Name *
Email Address *
Are you currently resident in the United Kingdom? * Yes/No Yes No
How did you hear about this role? * Please select from the list Social Network Employee Referral Company Website Linkedin Job Board Twitter Facebook CV-Library Indeed Other
Which role are you applying for? * Please enter the role you are applying for Care Home Support Worker Head of Finance & Operations
Are you looking for full or part time work? Select Full Time Part Time
How many hours per week are you available to work?
Are you able to work some evenings, weekends or nights? Yes/No Yes No
Address *
Best contact number *
Do you consider that you have a disability or are disabled, including any neurodiverse conditions? * Yes/No No Yes
If 'Yes', please specify below: *
Do you require any reasonable adjustments? * Yes/No No Yes
If 'Yes', please specify below: *
Would your disability prevent you from lone working? * Yes/No No Yes
If 'Yes', please specify below: *
Would your disability prevent you from working out of hours or overnight? * Yes/No No Yes
If 'Yes', please specify below: *
Could any aspect of your disability create an environment where vulnerable adults might be at risk? * Yes/No No Yes
If 'Yes', please give details below: *
Do you have a current, full driving licence? * Yes/No Yes No
Do you have your own transport? * Yes/No Yes No
To the best of your knowledge, do you have any connection with any past or present resident, member of staff or director of Crossways Community? * Yes/No No Yes
Resident/staff member/director's name. *
Do you have a current UK Passport? * Yes/No Yes No
Are you free to remain and take up work in the UK? * Yes/No Yes No
If offered the position, will you continue to work in any other capacity? * Yes/No Yes (further information will be required) No
Do you have any unspent conditional cautions or convictions under the Rehabilitation of Offenders Act 1974? * Yes/No Yes No
Do you have any adult cautions (simple or conditional) or spent convictions that are not protected as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020? * Yes/No Yes No
Do you require any special arrangements to be made for your interview on account of a disability? * Yes/No Yes No
Are there any gaps in your CV? * Yes/No No Yes (further details will be required)
I confirm that Crossways Community may contact referees (and any previous employer) to verify that I am a suitable person to be employed. * Please confirm your acceptance of this statement I confirm
Please confirm that Crossways Community may use my personal data for personnel, management and monitoring purposes * Please confirm your acceptance of this statement I confirm
I confirm that I understand that it is a requirement that a DBS certificate will be obtained which will include details of any criminal convictions, cautions, reprimands, final warnings or any other information that might have a bearing on the post * Please confirm your acceptance of this statement I confirm
I confirm that the information I have given on this form is correct and complete, and that if I have given incorrect or misleading statements or have knowingly witheld information, it may be sufficient grounds for immediate dismissal at any time. * Please confirm your acceptance of this statement I confirm
