The Prince Of Wales Hospice Careers

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Personal Details

First Name *

Last Name *

Email Address *

Mobile Number *

Home Number

Upload your CV *

Address Information

Street Address *

City *

County *

Country *

Postcode *

References

Please provide the names, addresses and contact numbers of two referees covering a minimum of your last 3 years of employment (where possible). At least one referee must be your present or most recent employer.

Referee 1:

Name:

Job Title:

Address & Postcode:

Telephone Number:

Email:

Relationship:

Can the referee be approached prior to interview?

Referee 2:

Name:

Job Title:

Address & Postcode:

Telephone Number:

Email:

Relationship:

Can the referee be approached prior to interview?

Criminal Offences

Please see recruitment information for details of whether this post is subject to a Disclosure and Barring Service Check (DBS Check). If so, the following is applicable and must be completed: Please see recruitment information for details of whether this post is subject to a Disclosure and Barring Service Check (DBS Check).

If so, the following is applicable and must be completed:

The Prince of Wales Hospice is exempt from the provisions of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act (Exceptions) Order 1975. Applicants are not entitled to withhold information about convictions, cautions, warnings, reprimands or binding overs which for other purposes are "spent" under the provisions of the Act. Any information provided will be confidential and will be considered only in relation to the post to which the order applies.

Failure to reveal information could lead to a withdrawal of an offer of employment. In the event of any employment, failure to disclose this information could result in dismissal or disciplinary action.

Have you ever been convicted or a criminal offence, received bind overs or police cautions?

Eligibility to Work in the UK

As an employer, we have a responsibility to prevent illegal working and to ensure you are legally entitled to work in the UK. Are there any restrictions to your residence in the UK which might affect your right to take up employment with us?

If yes, please provide details:

If you are offered a position with the Hospice, you will be required to provide original documentary evidence of your eligibility to work in the UK.

Relationships/Connections to Hospice

Are you related to anyone employed or who volunteers at the Hospice? Please note this should be declared but is unlikely to affect recruitment.

If yes, please provide details:

Declaration

I declare that the information given on this form and the Equal Opportunities Monitoring Form is accurate and true. I understand that providing misleading or false information will disqualify me from appointment or, if appointed, may result in my dismissal.

I understand that an appointment, if offered, will be subject to satisfactory medical clearance, references, registration (if appropriate), compliance with the Asylum and Immigration Act and, if required, a Disclosure and Barring Service (DBS) check. If a DBS check is required I give permission for the application and processing of this.

The information provided by me may be processed for purposes permitted under the General Data Protection Regulation. Individuals have, on written request, the right of access to personal data held about them. The organisation treats personal data collected during the recruitment process in accordance with its Data Protection and Privacy Policies which are available on our website.

Signature:

Date:

About My Application

I confirm that my details are complete and correct
I confirm I have the right to work in the country where this job is based
I confirm I have read and agreed to the privacy policy