Application form | Dorothy House Hospice Care

Dorothy House - Candidate Portal

Contact details

Education / Qualifications

Employment history

Professional identification

Supporting information

Equal opportunities

Step 1: Contact details

Title*

First name*

Last name*

Email address*

Phone number*

Address lookup*

Address Line 1*

Address Line 2

Address Line 3

Town*

County*

Postcode*

Step 2: Education and qualifications

Please include any relevant qualifications or CPD information for the role you are applying for.

School / College / University

From

Subject / Qualification obtained

From	To	Where	Qualification

Step 3: Employment history

Please include your full employment history starting with your most recent employer. Please make sure to highlight any employers where you have worked with children or vulnerable adults.
If you have not worked before, please state “I have not worked before” in the mandatory fields and put your date of birth as employment start date.
As part of our Safer Recruitment process, we also need to clarify any gaps in employment outlined in your application. If there are any gaps in your employment history (e.g. sabbatical, unemployment, travel) please write “GAP” in the mandatory fields, along with a brief summation of the details in the duties and responsibilities section.

Name of company*

Job Title*

From (mm/yyyy)*

To (mm/yyyy)

Notice Period

Please provide a brief overview of your duties and responsibilities

From	To	Name

Step 4: Professional identification and/or membership

Professional Institution, e.g. NMC, GMC, HCPC

Professional Identification Number, e.g NMC (if applicable)

Expiry (mm/yyyy)

Name	Expires

Step 5: Information in support of your application

Is there anything else you would like to tell us in support to your application? This could be either by typing in the box below, adding a cover letter, or adding a short video.

Cover Letter

To support your application, please demonstrate how your attributes, skills and previous experience relates to our values

Step 6: Confidential equal opportunities monitoring

Dorothy House Hospice is committed to pursuing equality of opportunity and recognises the benefits of having a diverse workforce. To achieve this, we would be grateful if you would answer the following questions.

This form will be separated from your Application Form and will not be used as part of the decision making or selection process for this vacancy. Should a disability be highlighted, this will be shared with the relevant hiring team to ensure we take all reasonable steps to accommodate any needs you may have during the interview process.

Thank you for your help.

Please indicate your sex

Male Female Prefer not to say

Date of birth*

Please indicate the option which best describes your marital status

Please indicate your ethic origin

What is your sexual orientation?

Please indicate your religion or belief

Do you consider yourself to have a disability?

Declaration I understand that any offer of employment may be withdrawn if I have knowingly withheld information, provided false or misleading information and that my employment may be terminated should any subsequent information come to light once I have been appointed. I give my authorisation for any of the information disclosed on this application form, and relevant documents, to be checked for authenticity and I agree that any deliberate omission, falsification or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal if employed by the Hospice.*

Pre-qualification questions

Please answer the following questions