Which job are you applying for?
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Personal Details: |
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Title |
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Forenames |
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Surname |
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Address |
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Post Code |
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Tel. |
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Email. |
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National Insurance No. |
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Do you hold a current British Driving Licence |
Yes
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No
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Do you have daily use of a car? |
Yes
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No
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About where you live: |
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Do you live in a |
House
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Bungalow
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Maisonette
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Flat
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Is it |
Owned
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Privately Rented
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Council Rented
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Do you have sole use of your garden? |
Yes
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No
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Is your garden completely secure on all sides? |
Yes
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No
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About you: |
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Other than holidays are there any other times of the year you will be unable to care for a dog? |
Yes
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No
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If yes, give details |
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Do you have any regular daily commitments that may take you away from your house for longer than 2 hours? |
Yes
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No
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If yes, give details |
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What is the maximum number of dogs you could accommodate in your house - 1,2 or 3? |
Dogs |
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As a VIPs carer you may be asked to care for puppies, elderly or special needs dogs. You may be asked to wash/bath/groom a dog, to exercise it 3 times a day, and to administer oral medication. Would you object to providing any of these services? |
Yes
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No
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If yes, give details |
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About your family: |
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Do you live with other people? |
Yes
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No
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Name |
Relationship |
Age |
1 |
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2 |
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3 |
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4 |
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Do you have any other pets? |
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Yes
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No
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If yes, give details |
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About your experiences: |
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Have you ever owned your own dog? |
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Yes
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No
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If yes, give details |
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Have you ever worked with dogs? |
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Yes
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No
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If yes, give details |
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Have you ever been banned from keeping animals? |
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Yes
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No
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If yes, give details |
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Under the terms of Animals Establishments Act 1963, carers must supply details of a relative, friend or neighbour who will act as a "key holder" for their property in the event of fire or emergency. Please provide details of that person below: |
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Secondary Education: |
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Examinations Taken |
Level |
Grade |
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High and Professional Qualifications |
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Examinations Taken |
Level |
Grade |
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Present or Last Job: |
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Name and Address of present or most recent employer |
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Job Title |
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Employment Dates |
From
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To
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Current or last earnings (gross) |
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Notice required by your present employer |
months |
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Reason for leaving |
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Supporting Information:
Please give a description of your present or most recent employment along with any other relevant information in support of your application. Include any details of your interests if these are relevant to this application. |
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References: |
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Name |
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Relationship |
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Tel. No. |
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May we take up references prior to the interview? |
Yes |
No |
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Name |
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Relationship |
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Tel. No. |
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May we take up references prior to the interview? |
Yes |
No |
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