EMPLOYMENT APPLICATION FORM
Position applied for: Therapy Assistant (30 hours per week)
Date of Application: ……….
St Clare Hospice Hastingwood Road Hastingwood Essex CM17 9JX
Tel: 01279 773700 Fax: 01279 773701 E-mail:
24-hour Adviceline: 01279 773773 Website:
Company Limited by guarantee Registered in England No. 3398955 Registered Charity No. 1063631
St Clare Hospice Hastingwood Road Hastingwood Essex CM17 9JX
Tel: 01279 773700 Fax: 01279 773701 E-mail:
24-hour Adviceline: 01279 773773 Website:
Company Limited by guarantee Registered in England No. 3398955 Registered Charity No. 1063631
EQUAL OPPORTUNITIES STATEMENT
St Clare Hospice is committed to the principle of equal opportunities in employment, volunteer recruitment and access to services and opposes all forms of unlawful or unfair discrimination on the grounds of colour, race, nationality ethnic or national origin, gender, sexual orientation, marital status or disability.
We believe that it is in the best interests of the organisation and all those associated with it to ensure that the human resources, talents and skills available throughout the community are considered when, in particular, employment and volunteering opportunities arise.
To this end, within the framework of the law, we are committed wherever practicable to achieving and maintaining a staff and volunteer workforce which broadly reflects the local community in which we operate. We are also committed to providing complete equality of opportunity in access to our services which will always be provided on the basis of clinical need alone.
Every possible step will be taken to ensure that individuals are treated equally and fairly and that in particular, decisions on recruitment, selection, training, promotion and career management are based solely on objective and job-related criteria.
St Clare Hospice Hastingwood Road Hastingwood Essex CM17 9JX
Tel: 01279 773700 Fax: 01279 773701 E-mail:
24-hour Adviceline: 01279 773773 Website:
Company Limited by guarantee Registered in England No. 3398955 Registered Charity No. 1063631
Equal Opportunities MonitoringIn strict confidence
To help develop and implement our Equal Opportunities Policy all applicants are requested to answer the following questions. This information will be used solely for monitoring purposes and treated as confidential. It will be separated from your application form on receipt and before consideration of candidates takes place. (Ethnic group and nationality are based on 2011 Census)
Application for the post of: ......
Surname: ...... / Initials: ......
What is your ethnic group?
/ Choose one section from A to E, then tick one box to best describe your ethnic group or background
- A.
/ English / Welsh / Scottish / Northern Irish / British / / African
/ Irish / / Caribbean
/ Gypsy or Irish Traveller / / Any other Black / African / Caribbean background, write in
/ Any other White background, write in / ......
......
B. / Mixed / multiple ethnic groups / E. / Other ethnic group
/ White and Black Caribbean / / Arab
/ White and Black African / / Any other ethnic group, write in
/ White and Asian / ......
/ Any other Mixed/multiple ethnic background, write in
......
C. / Asian or Asian British
/ Indian
/ Pakistani
/ Bangladeshi
/ Chinese
/ Any other Asian background, write in
......
How would you describe your national identity?
Tick all that apply
/ English / / Northern Irish
/ Welsh / / British
/ Scottish / / Other, write in ......
Are you? / Male / / Female /
Would you describe yourself as a person with a disability? / Yes / / No /
Age Category : < 20 21-30 31-40 41-50 51-60 > Prefer not to say
St Clare Hospice Hastingwood Road Hastingwood Essex CM17 9JX
Tel: 01279 773700 Fax: 01279 773701 E-mail:
24-hour Adviceline: 01279 773773 Website:
Company Limited by guarantee Registered in England No. 3398955 Registered Charity No. 1063631