application for employment

Personal Details

Do you need a work permit/visa to work in the UK? *

Where did you hear about vacancies at Saint Cecilia's? *

About the position applied for

If you obtained this position, would you continue in any other employment? *

Do we need to make any disability-related adjustments to allow you to take part in the recruitment process? *

Centre *

Please indicate which shifts you would be prepared to work *

Have you previously worked for us? *

Employment and education


List your present and past employment, starting with the most recent. Please list the name and address of the company, and the type of business; the start date, end date of employment; and provide a description of your role.


List your education history, starting with the highest qualification obtained. Please list the name of the school, college or university; the qualification obtained; and the date the qualification was obtained.

Nurse Information


Please provide the details of two people (not relatives), one of who must be your last employer that we could approach for references. Please include their full names, occupation, address, telephone number, and email address.


Please note, you will be required to complete a Medical Questionnaire if offered a position.

Rehabilitation of offenders act

Declaration under the Protection of Freedoms Act 2012

The post for which you are applying is a ‘regulated activity’ within the meaning of Part 5 Chapter 1 of the Protection of Freedoms Act 2012 and it is a criminal offence for a ‘barred person’ to apply to work in a regulated activity. If you are a barred person you must not proceed with this job application.

If your application is successful you will be required to co-operate with us in obtaining a disclosure of criminal convictions and in checking your barred status with the Disclosure and Barring Service.

Are you a barred person? *

Do you have any outstanding safeguarding investigations or suspensions, criminal prosecutions or convictions that might lead to your being barred from working on child-orientated premises (e.g. schools), with children or with protected adults? *

Do you have any convictions, cautions, reprimands or final warnings that would not be filtered in line with current guidance? *

DBS Update Service - Are you signed up to the DBS Update Service? *

Question asked under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Do you have any physical or mental health conditions which are relevant to your capability, after reasonable adjustments are made, to properly perform the tasks which are intrinsic to this employment? *


The above information is true. I understand that any job offer made on the basis of untrue or misleading information may be withdrawn or my employment terminated.

By checking the box below, I hereby declare that the information I have provided is true and correct *



Regulated activity

All information will be treated as strictly confidential and no approach will be made to any person without your permission.

Privacy notice

We process personal data relating to those who apply for job vacancies with us or who send speculative job applications to us. We do this for employment purposes, to assist us in the selection of candidates for employment, and to assist in the running of the business. The personal data may include identifiers such as name, date of birth, personal characteristics such as gender, qualifications and previous employment history.

We will not share any identifiable information about you with third parties without your consent unless the law allows or requires us to do so. The personal data provided during an application process will be retained for a period of at least six months or, if required by law, for as long as is required.

This privacy notice does not form part of an employment offer or contract between us. If we make an employment offer to you, we will provide further information about our handling of your personal information in an employment context separately.

If you would like to find out more about our data retention policy and how we use your personal data, you want to see a copy of the information about you that we hold or have any questions or issues regarding data protection, please email us with the Subject “Data Protection Request”.

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