Application for work

Before you start, please take a moment to read through each section and get the required information you need. If you miss any sections you may be asked to complete the application again. If you have any questions, please call us on 020 8858 5958.

Personal Details


Emergency Contact

5 Year Career History

Please complete the entries below clearly stating your employment history for the last 5 years. Please note that all periods must be accounted for including maternity leave, unemployment, visits to other countries etc. Please ensure that you write the start month and year, and finish month and year for each job/ period of other undertaking. Please note that periods of over one month must be verified by a suitable professional person (e.g. Job centre plus official, doctor, teacher etc.)

  • Please provide as much detail as you can. We will need to contact these organisations to verify your work history.
  • Please start with the most recent first, and work chronologically backwards.
  • Please don't leave the 'date finished' field blank if still employed in this role.

Please provide at least 1 work history.
Please sign at the bottom to verify your work history and to give consent for us to contact the listed workplaces.

Career History 1

Career History 2


Professional Qualifications & Training

Please enter your professional qualifications into the fields below. Note, if unqualified please state 'unqualified'.

Please give the dates of training such as:


Please tick if you have experience in each of the following areas.
You must have experience in at least 1 category.

Rehabilitation of Offenders

The post that you have applied for is excepted from the Rehabilitation of Offenders Act 1974, which means all convictions, cautions, reprimands, spent convictions and final warnings on your criminal record need to be disclosed. Please be aware that an Enhanced Disclosure will be sought through the Criminal Records Bureau in the event of a successful application.

Only relevant convictions and other relevant information will be taken into account so disclosure need not necessarily be a bar to obtaining this position.


If yes, please specify details

Police Enquiries


Name History

Have you used any other first or last names? If so, please specify.

Please note - It is important that you do not leave any date gaps between name changes.

5 Year Address History

Have you changed address in the last 5 years.

Please note - It is important that you do not leave any date gaps between address changes.

Disqualification by Association Declaration

Bretsa are required to ask all employees to make a declaration about whether they are a disqualified person under the Childcare (Disqualification) Regulations 2009.

A person may be disqualified under the regulations because:

  1. They have certain orders, directions or restrictions placed upon them in relation to children or childcare
  2. They have been cautioned or convicted of certain offences
  3. They live or work in the same household as someone who is disqualified

You are required to complete the declaration below confirming that you are not disqualified under these regulations.

Section 1 - Orders or other restrictions


Section 2 - Specified and Statutory Offences

Have you ever been cautioned, reprimanded, given a warning for or convicted of:


Section 3 - Disqualification by Association


Section 4 - Provision of Information

If you have answered YES to any of the questions above you should provide details below in respect of yourself, or where relevant the member of your household: (You may provide this information separately if you wish, but you must provide this without delay).

Section 5 - Declaration


Bank Details

Please note - if you do not submit your details with your first timesheet there will be a delay in your payment

(8 digits)

(6 digits)

Eligibility to Work Within the UK


Working Hours

Current law states that Bretsa Recruitment must limit your work to 48 hours per week unless you declare otherwise. You may refuse work at any time and will never be asked to work over 48 hours per week. However you may do so if you choose that the limit shall not apply to you. Bretsa Recruitment wishes to have an agreement with you.

It proposes an agreement (which will apply until terminated by notice) on the basis that:

  1. The 48-hour limit on average weekly working time will not apply to you;
  2. You may terminate the agreement (so that the 48-hour time limit would apply to you) by giving the person at the Company to whom you usually report 4 weeks written notice.

Under the Regulations, the Company must keep records relating to your working time.
This is the case whether or not you reach an agreement with the company about waiving time limits.

Please read the statement below and delete as appropriate:


Health and Disability

The following questions on health and disability are asked in order to find out your needs in terms of reasonable adjustments to access our recruitment service and to find out your needs in order to perform the job or position sought.


If you have a disability, what are your needs in terms of reasonable adjustments to enable you to perform the role sought?

If you have a disability, what are your needs in terms of reasonable adjustments in order to access this recruitment service and to attend interview, or to take aptitude tests etc?


Curriculum Vitae

Please upload an up to date CV - simply browse and choose your recent CV then press upload.

Previous Agency Placements Since 1st October 2011

Since 1st October 2011, have you worked for the same nursery, school or setting for more than 12 weeks without taking a break of at least 6 weeks?

If yes, please state the agency, nursery/school/setting name, dates (mm/yyyy) and duration of placements.

Data Protection Statement

The information that you provide on this form and on any CV given will be used by Bretsa Recruitment to provide you work finding services. In providing this service to you, you consent to your personal data being included on a computerised database and consent to us transferring your personal details to our clients. We may check the information collected, with third parties or with other information held by us. We may also use or pass to certain third parties information to prevent or detect crime, to protect public funds, or in other way permitted or required by law.


I hereby confirm that the information given is true and correct. I consent to my personal data and CV being forwarded to clients. I consent to references being passed onto potential employers.

If, during the course of a temporary assignment, the Client wishes to employ me direct, I acknowledge that Bretsa Recruitment will be entitled either to charge the client an introduction/transfer fee, or to agree an extension of the hiring period with the Client (after which I may be employed by the Client without further charge being applicable to the Client).

Terms and Conditions


By sending this application, I declare the information in this application to be true & correct. I understand that if any of the data is untrue, misleading or I have failed to declare facts, future employment offers may be withheld or removed without Notice.