Job Application

Care with Heart is passionate about supporting people with learning disabilities, to challenge their limitations, and find new and innovative ways to help people take risks and live the life they choose, and to have the leading role in their own lives.


Your Details Your Address
Do you need a Work Permit in order to take up this post? Do you hold a full UK/European driving licence?
Please detail here any specific needs in relation to possible interviews
If you obtained this position, would you continue in any other employment?
Employer information

Please read the job description and person specification before answering the following question:

If your ability to undertake the responsibilities of the job are limited in any way, how could we help you to overcome these limitations?
Full Employment Record

+ Add Employment Please give details of all previous jobs including any employment outside of the UK that you have held starting with the most recent. Please give a brief explanation for any gaps in employment.

Employment 1:
Employment 2:
Employment 3:

+ Add Qualifications Please list any qualifications you have gained (e.g. GCSEs, A-Levels, Degree, NVQs, Professional qualifications)

Qualifications 1:
Qualifications 2:
Qualifications 3:
Other Training

+ Add Training Please list any other training you have undertaken which is relevant to the post you are applying for

Training 1:
Training 2:
Training 3:
Relevant Skills and Experience

Please give details here of any experience and skills which you feel are relevant to the post. Include a description of your present job if appropriate.

Have you ever previously applied for a position with Care with Heart?

How do you think your skills and experience incorporate Care with Heart’s values?

Please explain why you wish to apply for the position.

If you are currently employed, please give your salary
When would you be available to start work?
Where did you see this post advertised?

Please give details of two professional referees who can confirm that you meet any selection criteria listed for the post. One must be your current employer (or last if you are unemployed), the second should be a past employer. Both referees must be line managers you have worked for.

First Reference:
Second Reference:
May we contact these Referees or any of your previous employers without further authority from you?

Please note that it will not be possible to make a formal offer of appointment until Satisfactory References and DBS (Disclosure and Barring Services) Adults and Children Barred List have been obtained.

Equal Opportunity Monitoring

Care with Heart is an Equal Opportunity employer. Care with Heart operates a policy the aim of which is to ensure that unfair discrimination does not take place in recruitment. In order to help us monitor the effectiveness of this policy (and for no other reason), you are asked to provide the information requested below. The Equality Act 2010 requires equal treatment in access to employment regardless of age, disability, gender, marriage or civil partnership, maternity or pregnancy, race, religion or belief, sex and sexual orientation. This information is confidential and does not form part of your application.

Do you consider that you have a disability?

The Equality Act 2010 protects people with disabilities, including people with long-term health conditions.


Declaration For The Rehabilitation of Offenders Act 1974 (Regulated Positions)

The post for which you are applying is a regulated position. It is a criminal offence for a disqualified person to apply to work in a regulated position. The post is also exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974, by virtue of the Exceptions Order 1975 as amended in 2013. This means that all convictions, including those that are ‘spent’ under the terms of the Rehabilitation of Offenders Act 1974, but excluding those that are ‘protected’ under the Exceptions Order, will be made known to us. The information provided will be taken into account in deciding whether to make an appointment or not. It will be completely confidential and will be considered only in relation to this application. If your application is successful you will be required to co-operate with us in obtaining a disclosure of criminal convictions from the Disclosure and Barring Service (DBS).

Are you a disqualified person?

Do you have any unspent convictions, cautions, reprimands or warnings?

If you have previously had any other surname(s) or forename(s), you must declare all of them here and state the date of each change and the reason.