st davids hospice care application form

Job Application form

Personal Details

Right to work in the UK (Asylum & Immigration Act 1996)

You will be required to produce original documents to prove your eligibility at the interview/assessment stage and bring photocopies of them. Please don't forget to bring them with you, otherwise we will not be able to progress your application any further.

Particular requirements


Offers of employment are subject to two satisfactory references, one of which must be from your present or most recent employer. Please provide details below of your referees. Please note references will not be sought until an offer of employment has been made. If you are unable to provide two employment references please provide an academic reference or a volunteering reference.

Reference 1

Reference 2

Employment or volunteering history

Please start with the most recent period of employment

Previous employer/position

Previous employer/position

Previous employer/position

Previous employer/position

If YES please give their name and relationship to you


Please give details of the Schools/Colleges/Universities you attended
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Please include all academic, technical and professional qualifications, plus dates awarded.
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Please detail any professional bodies you are a member of

Driving licence details

Only complete if applicable to position

Do you have any endorsements? If yes please give details

Rehabilitation of offenders


Please show your maximum range of availability where applicable to role

For part-time roles, what is the minimum and maximum number of hours you are willing to work per week?

Additional information

Applicant's declaration

The information on this form will be held and used by St David’s Hospice in accordance with the provisions of the Data Protection Act 1998 and all relevant subsequent legislation. This information will be held and processed for the purpose of personnel/payroll administration and statistical analysis.

Diversity monitoring form

The information we collect is stored confidentially and securely. Data Legislation protects you and your data. All personal information is stored confidentially and can only be accessed by authorised persons in the Human Resources office. Once collected, this information can show us who is joining and leaving and ensures that all staff are treated fairly. Completing this information will help us to deliver against our diversity commitments and contribute to an inclusive working environment for all colleagues. We respect an individual's right not to disclose this information. For this reason, a 'prefer not to say' option is included.

St. David's believes that people should be judged, not by their age, but according to their skills and abilities at work. By monitoring our colleagues age we can ensure that opportunities for development and promotion are open to everyone.


Colleagues with a disability are entitled to reasonable adjustments under the law to enable them access to work.


By monitoring ethnicity, we can compare our recruitment pattern against the data collected in previous years’ National Census. This can show whether we attract people to work for us from all communities and whether as an employer, we reflect the communities we serve. We can also show whether all groups are treated fairly.

Religion or faith

Telling us about your religion or belief allows us to understand and plan to meet the particular needs of staff. It helps us to think about how we can accommodate requests to meet people's religious needs and faith. Knowing the religion of the staff helps us create an environment where all beliefs are respected.

Sexual orientation

Monitoring whether people are lesbian, gay, bisexual or heterosexual acknowledges that we value all staff and the contribution they bring to our business. An open and inclusive culture creates an environment where all colleagues can feel comfortable disclosing their sexuality. We know that people perform better when they can be themselves.
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