Hospice Isle of Man Job Application Form

Position Applied for:*

Notice Period or earliest start date:*

Where did you hear about the vacancy?*

Full Name*

PrefixFirst NameLast Name

Known as (Optional):

Current Address*

Street Address

Street Address Line 2

Town or CityCountry

Post Code

Email Address*

Phone Number*

Do you require an Isle of Man work permit?*

YesNo

For more information on Isle of Man Work Permits please click here

You will be required to undergo a Disclosure and Barring Search (DBS) check. Do you consent to this being carried out?*

YesNo

Please note that a Disclosure and Barring Search check is mandatory for all Hospice Isle of Man roles.

You will be required to undergo a Pre-Employment Medical Assessment with Occupational Health. Do you consent to this being carried out?*

YesNo

Please note that a Pre-Employment Medical Assessment is mandatory for all Hospice Isle of Man roles.

Do you hold a full current driving licence and have access to a vehicle?*

YesNo

Please check the job specification to make sure that holding a full current driving licence and having access to a vehicle is not an essential requirement for the role you are applying for.

Any dates and times during the next month when you are unable to attend for interview?

Details of any holidays booked

Employer

Salary

Position Held

Reason for leaving / wishing to leave

Referee Details 1

Referee Name 1 *

First NameLast Name

Referee Occupation (if applicable)

Company Name (if applicable)

Address*

Street Address

Street Address Line 2

CityCountry

Post Code

Email Address*

Phone Number*

Referee Details 2

Referee Name 2*

First NameLast Name

Referee Occupation (if applicable)

Company Name (if applicable)

Address*

Street Address

Street Address Line 2

CityCountry

Post Code

Email Address*

Phone Number*

Upload Your CV and Covering Letter (if applicable)*

Rehabilitation of Offender Act 2001

This post is exempt from the provision of the rehabilitation of Offenders Act by an Exemption Order. Therefore applicants are not entitled to withhold information about convictions or cautions which for other purposes under the Act are "spent”. Failure to disclose any such conviction could result in dismissal or disciplinary action. I understand that this appointment, if offered, will be subject to the information given on this form being correct. With the exception of minor motoring offences, have you ever been convicted or cautioned of any criminal offence by a Court of Law?*

YesNo

You have selected yes to the previous question - please provide brief details of the offence(s) and relevant details below:

Employee Declaration & Signature

ANY PERSON, UPON SUBSEQUENT EMPLOYMENT, THAT IS FOUND TO HAVE KNOWINGLY SUPPLIED FALSE OR MISLEADING INFORMATION, OR HAS DELIBERATELY WITHHELD RELEVANT INFORMATION, WILL BE SUMMARILY DISMISSED.

I have read and understood the information supplied to me in relation to this Job Position, and the information requested in this Job Application Form. I confirm that all information supplied by me is true and correct to the best of my beliefs.

I give the prospective employer the right to follow up all references and to make any other job-related enquiries as may be deemed necessary.

The information provided on this application form will remain private and confidential and will be used for the purpose of recruitment and selection. Where the application is successful, Hospice Isle of Man will process this information for personnel administration and business management purposes. Any data collected by Hospice Isle of Man will be in compliance with the requirements of the EU General Data Protection Regulation (GDPR) May 2018. Where the application is unsuccessful we will retain information for 6 months before being securely destroyed. Hospice Isle of Man, Share the Care Ltd and their associates will not pass your contact details to others without your consent. Refer to our privacy notice which can be found on our website or by contacting gdpr@hospice.org.im

Signature - Please sign to confirm the information contained in your job application is correct*

Please note that if you have a disability and you require having this form in larger print or submitting the information in another format, please contact the People and Culture team via telephone or emailing HR@hospice.org.im

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EmailSMS text message

Email

You can change your preferences or opt out of receiving communications at any time by contacting us on 01624 672222. Our Privacy Policy provides more information about how and why we use your personal data.

Hospice Isle of Man Job Application Form

Vacancy Details

Personal Details

Current Employment Details (if applicable)

References