Application Form

Contact Details

Equal opportunity

We value the diversity of our workforce and welcome applications from all sectors of the community. To ensure that our recruitment procedures operate fairly, please assist us in this process by completing the questions below.



Full Employment History

Please list below your complete and full employment history, explaining all employment gaps, starting with your most recent employer, working backwards to when you left full-time education (continue on a separate sheet if necessary).

Please also attach a full CV (if possible).
Click or drag a file to this area to upload.

Employer 1

Employer 2

Employer 3

Employer 4


Further Education

Qualifications and Training

Character References

Please provide details of two people who can be contacted for a reference if you have not provided a full 5 year work history.

The referee must be able to comment on your suitability and character for the post you have applied for (e.g. fellow work colleague or course tutor).

Relatives and/or Partners should not act as referees. Referees will not e contacted without your consent.

Reference 1

Reference 2

Additional Skills

Please use the space below to explain why you have applied for this vacancy. You should include details of your experience, skills and personal qualities that you can bring to this role.

You will need to refer to the enclosed job description and person specifications when completing this section.

Eligibility to work in the UK:

Other Employment

To Allow us to monitor your working hours and comply with current legislation, please complete the following section:

Disclosure of criminal record information

Due to the nature of the work for which you are applying, this post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974, by virtue of the Rehabilitation of Offenders 1974 (Exceptions) Order 1975.

This means that convictions that are 'spent' under the terms of the Rehabilitation of Offenders Act 1974 must be disclosed and will be taken into account in deciding whether to make an appointment.

Any information will be completely confidential and will be considered only in relation to this application.

Please read the above carefully and then answer the following questions:

Data Protection

The Livingways Care Service Recruitment Privacy Statement is available here or a copy can be requested from the Human Resources Department. Please sign below to confirm you have accessed the Livingways care services Recruitment Privacy Statement and you have read, understood and agree to all the terms stated.


I declare that the information given in this application is to the best of my knowledge, complete and correct. I accept that should any statement made by me in connection with this application be found to be false, incomplete or misleading then the application shall be void and consequently, we may terminate any contract arising at any time.

Because of the sensitive nature of the duties the postholder will be expected to undertake, I understand that the declaration will include details of any criminal convictions, cautions, reprimands and final warnings that are not 'protected' as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (2013) ad any other information that may have a bearing on my suitability for the post. I also understand that the relevant level of DBS check will be sought in the event of a successful application.

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