Apply to work in our shops

Please complete the application form below. For assistance please see the Guidance For Applicants.

If you are interested in working in other areas apply here.

If the below text area is available to you, please do not enter any data, otherwise your form will not be submitted

To register for this feature please enter you details in the form below. All items in bold are required.

RETAIL APPLICATION FORM

St Catherine’s Hospice is committed to equality of opportunity in both employment and service delivery. A policy statement and monitoring form are enclosed with this application form. Managers involved in the shortlisting process will make decisions based solely on the information you provided on this application form.

Application for the post of:

Closing date:

Forename(s):

Surname:

Email address

Home telephone number:

Alternative number:

Address:

Post code:

EDUCATION

School

Subject and Grade e.g. English C

Date attained:

College/Sixth Form

Subject and Grade

Date attained:

University

Subject and Grade

Date attained:

CURRENT OR MOST RECENT EMPLOYMENT

Employer:

Address:

Job title:

Date appointed:

Salary:

Notice required / date left:

Reason for leaving:

Describe the main duties and responsibilities of your present/most recent post:

PREVIOUS EMPLOYMENT (most recent first)

Employer:

Address:

Date from:

Date to:

Job title:

Brief description of duties:

Reason for leaving:

Employer:

Address:

Date to:

Job title:

Brief description of duties.:

Reason for leaving:

SUPPORTING STATEMENT

Drawing upon your experience, knowledge, skills and abilities, explain how you fulfill the requirements set out in the person specification. Experience may also have been gained through paid or voluntary work or in the home.

REFERENCES

Please give the name and address of three Referees who can comment on your skills, experience and personality. The Referees must be able to verify your employment history (or college/school where appropriate) over the past 24 months.

Current/most recent employer

Name:

Position:

Tel no:

Address:

Post code:

May we approach this referee prior to the interview?

Referee 2

Name:

Position:

Tel No:

Address:

Postcode

Job title:

May we approach this referee prior to the interview?

Referee 3

Name:

Position:

Tel No:

Address:

Postcode:

May we approach this referee prior to the interview?

HEALTH STATEMENT

Sickness absence may be discussed at interview. Successful candidates will be required to complete a declaration of health form and undergo an occupational health examination.

Please state number of occasions and number of days absent due to sickness over the last 2 years.

Number of days:

Number of occasions:

The Hospice does not discriminate against applicants with disabilities, please therefore assist us by completing the section below:

Do you consider you have a health problem or disability as defined under the Disability Discrimination Act 1995, which is relevant to your job application?

Please give details, including any adjustments to the workplace or post to enable you to perform in the post:

REHABILITATION OF OFFENDERS ACT 1974

Have you any convictions for any criminal offence which are not ‘spent’ under the provisions of the Rehabilitation of Offenders Act 1974?

If YES, please give details:

ASYLUM AND IMMIGRATION ACT 1996

If successful in your application for this post, you will be required to provide evidence of your entitlement to live and work in this country. Evidence of your National Insurance Number could include a P45, pay slip, P60, NI card or a letter issued by one of the Government bodies. Alternatively, a UK European Union or Republic of Ireland birth certificate or passport showing permission to live and work within the UK.

Are you in a position to provide this evidence?

Do you require a work permit to work in this country

If you are an overseas national, please give details of visa/permit currently held.

DECLARATION

Can you confirm that to the best of your knowledge there are no medical reasons which would prevent you from undertaking the duties of the post?

I understand that:-

the appointment, if offered, will be subject to information given on this form being correct;
providing false information with regard to this application shall disqualify me from such appointment, or in the future lead to a termination of employment.
any appointment is subject to the receipt of satisfactory references, a satisfactory occupational health clearance, Criminal Records Bureau Disclosure (if applicable) and successful completion of a three month probation period

Signature

Date:

St Catherine’s Hospice is a charity dedicated to providing specialised end of life care and support to local people and their families, friends and carers.	Your Feedback Privacy Statement Accessibility Location map
St Catherine’s Hospice Ltd. Registered as a Charity no. 281362 and as a Company in England no. 1525404 Registered Office: Malthouse Road, Crawley, West Sussex RH10 6BH Tel: 01293 447333