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Our Care
Support Us
- Donate
- Corporate
- Lottery
- Fundraising
- In Memory
- Events
- Gifts in Wills
About Us
Cafe Retreat
- Cafe Retreat
- Patient Nutrition
Retail
- Our Shops
- Shop Online
Join Us
Professionals
- Professionals
- Training and Education
News

Join Us

Job Application Form

Home Join Us Job Application Form

"*" indicates required fields

Step 1 of 6

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Your Details

Name*

First Last

Telephone Number*

Address*

Street Address County Post Code

Email Address*

Do you hold a full Current Driving Licence*

Yes

Are you presently a vehicle owner?*

Yes

Post applied for*

Where did you see this Job Advertised?*

Do you require any reasonable adjustments for the recruitment process?*

Yes

Please detail*

Education and Qualifications

General Education*

Please list any Qualifications, Levels, Grades, and Dates

Professional Qualifications*

Please list any Qualifications, Levels, Grades, and Dates

Post Graduate Qualifications*

Please list any Qualifications, Levels, Grades, and Dates

On- going study relevant to post*

Please list any Courses, Course Providers, Date Started and Date expected to complete

Details of other courses relevant to this post*

Please list any Courses, Course Providers, Date Started and Date expected to complete

PIN number / professional registration

Professional Body

Number

Expiry Date

Month

Day

Year

Have you ever been reported to your professional body?

Yes

Do you require a permit to work in the UK?*

Yes

Please give permit number*

Employment - Most Recent Current Employer

Company Name*

Address*

Street Address County Post Code

Post held*

Date started*

Month

Day

Year

Date left (if applicable)

Month

Day

Year

Notice Period required (if still in post)

As part of our recruitment process we need to ensure we have a full employment history from when you left full-time education, please ensure you explain any gaps in your employment.

Name of Employer*

Post Held*

Date From*

Month

Day

Year

Date To*

Month

Day

Year

Reason for leaving*

Add Another Post

Supporting information*

Please give a short description of your relevant knowledge, skills and skills to support your application for this post

References

Please give the details two referees (not relatives). These should be your most recent employer and previous employer if possible. For school leavers this should be from your school or college. If you are unsure in relation to who is able to give you a reference please discuss with the recruitment team. Both referees will be contacted after you have received your conditional offer of employment.

Name*

Company*

Address*

Street Address County Post Code

Telephone*

Email*

Relationship*

Add more

Please note only shortlisted candidates will be contacted

DBS, Data Protection & Declaration

Disclosure of Criminal Offences

If the role for which you are applying involves regular, direct, unsupervised contact with people receiving health care the post is exempt from the Rehabilitation of Offenders Act 1974. This means that if you are successful at interview the hospice will request an enhanced DBS check via our umbrella organisation “Personnel Checks” as part of the pre-employment screening process. You will then be asked to complete an online form by “Personnel Checks” to progress the DBS check. For more information on how the hospice will deal with information disclosed via DBS checks please refer to our Statement on Secure Storage, Handling, Use, Retention and Disposal of Disclosures and Disclosure Information which is available on our website.

Data Protection Statement

The information that you provide on this form and that obtained from other relevant sources will be used to process your application for employment. The personal information that you give us will also be used in a confidential manner to help us monitor our recruitment process. If you succeed in your application, the information will be used in the administration of your employment. We may also use the information if there is a complaint or legal challenge relevant to this recruitment process. We may also use or pass to certain third parties information to prevent or detect crime, to protect public funds, or in other ways as permitted by law. By signing the application form we will be assuming that you agree to the processing of sensitive personal data, (as described above), in accordance with our registration with the Data Protection Commissioner.

Declaration

To the best of my knowledge the details in this application are true I understand that any misrepresentation found in this application after appointment may lead to dismissal

Signature*