Please note all fields are required on this page only.
Job Title:
Nature of Business: Position Held: Nature of Responsibilities: Reason for Leaving:
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Please tell us about your education; beginning with the most recent. You must complete this section if higher education is a requirement for the specific position you are applying for. You may also include relevant training courses.
Have more Education, Training or Development to list? Yes
Have even more Education, Training or Development to list? Yes
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Please state all employment (starting with the most recent - including voluntary work). Please account for any gaps in employment. Failure to do so may result in your application not being considered.
Have you ever worked for Beatrice Loving Heart? YesNo
Please give the names and addresses of two people who would be willing to provide a reference concerning your application. One of the referees must be your current/last employer who will be asked specifically about your attendance record.
Reference Name: Reference Full Address: Reference Daytime Phone: Reference Email: Is this person your present or previous employer? YesNo
References might be contacted prior to your interview. Please indicate if your referee can be contacted at this stage. YesNo
References might be contacted prior to interview. Please indicate if your referee can be contacted at this stage. YesNo
If you have any personal relationship to any Administrator at Beatrice Loving Heart, Board Member of the agency or employee of the Agency, please give their name and relationship. Any approach to Councillors or other employees to influence a selection decision will disqualify you. This does not stop a Councillor or employee from giving a reference.
Please tell us when you are not available for an interview. This does not guarantee that we will be able to accommodate your needs, particularly after an interview date has already been indicated.
Beatrice Loving Heart supports individuals with a disability and is committed to their employment. The Agency’s policy is that any disabled applicant who meets the minimum (essential) criteria for the job will be interviewed.
Do you wish to apply under the Guaranteed Interview Scheme? YesNo
If the job for which you are applying requires you to drive or carries an essential car user allowance, please answer the following questions:
Are you a vehicle owner? YesNo
Do you hold a full clean current license? YesNo
Please state any other type of license you hold (e.g. HGV):
I certify that the information provided in this application form is accurate and true. I give my consent to the processing, transfer and disclosure by Beatrice Loving Heart of all the information submitted by me during the recruitment process and throughout my subsequent periods of employment for pre-employment checks, equal opportunities monitoring, payroll operations, training and absence records (Data Protection Act 1988). (Deliberate falsification or withholding of information will lead to disciplinary proceedings and may result in dismissal.)
I understand that canvassing will automatically disqualify my application. YesNo
Have you ever received or currently receiving any state or work-related benefits? YesNo
Beatrice Loving Heart aims to promote equality of opportunity for all with the right mix of talent, skills, and potential. We welcome applications from diverse candidates.
Why do I need to complete Equality & Diversity Questions?
The agency has a legal duty to promote equality. This duty applies to everything the agency does, both as an employer and a provider of services. In order to help us, please answer the following questions and complete the declaration at the bottom of the end page.
What happens to the Equality & Diversity information?
All data, in accordance with the Data Protection Act, will be confidentially retained and used only for the purpose of reporting to Committee and for the production of statistical reports. The Equality & Diversity data will only be recorded and maintained on the employee’s personal record on the Council’s Human Resources system and used for the purpose of statistical reports in relation to equality and performance indicators including recruitment.
What is your ethnic group? Please tick the relevant ethnic group. If you are in an ‘Any Other Background’ category please state what it is.
White: EnglishOther BritishIrishOther
Mixed: White & Black-CaribbeanWhite & Black-AfricanWhite & AsianOther
Asian or Asian-British: IndianPakistaniBangladeshiChineseOther
Black or Black-British: CaribbeanAfricanOther
Other Ethnic Group: ArabGypsy/Romany/Irish TravellerOther
Do not with to declare: Do not wish to declare
What is your country of birth? United States of AmericaMexicoScotlandCanadaNorthern Ireland Republic of IrelandOther
What is your religion or belief? NoneChristianBuddhistHinduJewishMuslimSikhHumanistAtheistAgnosticPaganOtherDo not wish to declare
What is your nationality? EnglishBritishFrenchSpanishOtherDo not with to declare
Do you speak any other languages? SpanishFrenchRussianChineseOther
The agency takes a positive approach in the selection of people with disabilities, including interviewing all disabled persons who meet the essential selection criteria. The Disability Discrimination Act 1995, defines disability as “a physical or mental impairment which has substantial and long-term adverse effect on the ability to carry out normal day to day activities”.
Do you consider yourself to be a disabled person? NoYes
Are you currently married? YesNoDo not wish to declare
Or in a civil partnership? YesNoDo not wish to declare
What is your gender? MaleFemaleDo not wish to declare
The details given by me are correct to my knowledge and belief. YesNo
Safer Recruitment & Employment Policy Statement
“Beatrice Loving Heart is committed to safeguarding and promoting the welfare of children, young people and vulnerable adults. We expect all our employees and volunteers to share this commitment.”
Have you ever been convicted, or received a caution, warning or final reprimand, for an offense that will not be filtered from the background check? NoYes
The details given by me are correct to my knowledge and belief. I understand that my application may be rejected or my employment may be terminated for withholding relevant details or giving false information. YesNo
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