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Dorset Mind Employment Application Form

Using this Application Form

All sections on this form are to be completed clearly. Please ensure you read in full the Job Description and Person Specification before filling out your application. Forms that do not meet requirements set out in these guidance notes will not be considered.

Data Protection

In accordance with our Privacy Statement (which can be viewed on our job vacancies webpage), we take care to ensure all applicant data is appropriately and securely stored and handled. Any information supplied in connection with an application for employment will be kept securely for a period of six months and then will be destroyed.

Any information with regards to successful candidates who are subsequently employed by Dorset Mind will be moved into their staff file and be handled in line with our Retention and Disposal Schedule.  If you have any further information about our approach to Data Protection, please see the Privacy Notice on our website or contact us via recruitment@dorsetmind.uk

Criminal Convictions

As part of its equal opportunities policy, Dorset Mind wishes to ensure it does not discriminate against ex-offenders.  If you have any convictions that are unspent under the Rehabilitation of Offenders Act 1974, please supply details of your conviction(s) via the personal details section of this form.

Some posts are exempt from the Rehabilitation of Offenders Act 1974 as they involve working with vulnerable adults and will require a Disclosure and Barring Service (DBS) check.  If you have applied for an exempt post, please supply details via the personal details section of this form.

Eligibility to work in the UK

If there are any restrictions regarding your employment in the UK (e.g., you require a Work Permit), please supply details via the personal details section of this form. Please note Dorset Mind is not able to sponsor Visas.

Equal Opportunities

Dorset Mind is an Equal Opportunities Employer and welcomes applicants from a diverse range of backgrounds.

Personal Details (this section will be removed before shortlisting)

 This part of the form is used to collect information about you in the event that you are shortlisted for the role you are applying for and to make us aware of any restrictions to your employment.

The information from this section of the form will not be shared with the recruitment panel until after shortlisting has taken place.

Equality Monitoring Form

Dorset Mind is committed to a culture for staff, volunteers, and participants that promotes equality and celebrates diversity. To help us monitor and achieve this, we gather and use information to continually improve our policies and processes and to remove barriers to either working with us or accessing our services. The information you give is confidentially managed and will not affect your participation in our services, or your application to work/volunteer with us.
It will help us if you provide as much information as possible, but if you do not wish to answer any questions please leave them blank.

Gender

Female
Male
Non-binary
Transgender
Prefer not to say

Sexual Orientation

Bisexual
Gay Man
Gay Woman / Lesbian
Heterosexual/Straight
Non-Binary/Pan-Sexual
Prefer not to say

Do you consider yourself to have a disability or long-term condition that has a substantial impact on your ability to carry out day-to-day activities (including sight or hearing loss)?

Yes
No
Prefer not to say


If you answered yes is it:
A Physical Health Condition
A Mental Health Condition
Prefer not to say

Do you consider yourself to be neuro-diverse (i.e., on the autism spectrum)?

Yes
No
Prefer not to say

Do you have a learning difference? (this can include dyslexia etc)

Yes
No
Prefer not to say

Ethnicity

Black

African
Carribean
Other Black Background
White

British
Irish
Eastern European
Another White Background


Asian

Bangladeshi
Chinese
Indian
Pakistani
Another Asian Background
Mixed

White & Asian
White & Black African
White & Black Carribean
Another Mixed Background


Other ethnic group

Arab
Gypsy or Traveller
Another Background
Prefer not to say

Religion and belief

Agnostic/Atheist
Hindu
Muslim
Buddhist
Jewish
Sikh
Christian
None
Other


prefer not to say

Relationship Status

Single
Married/Civil Partnership
Separated
Widowed
Divorced
with Partner
Prefer not to say

Other Information

Prefer not to say

Prefer not to say

Are you a Carer?

Yes
No
prefer not to say


Application Form

The information from this section of the form will not be shared with the recruitment panel until
after shortlisting has taken place.

Application Information

Your Details

Yes
No

Eligibility to work in the UK

If there are any restrictions regarding your employment in the UK (e.g., you require a Work
Permit), please supply details below. Please note Dorset Mind is not able to sponsor Visas.
I have no restrictions regarding my employment in the UK
I have restrictions regarding my employment in the UK (please give details below)

Criminal Convictions Declaration

As part of our equality and diversity policy, we wish to ensure we do not discriminate against ex-offenders. If you have any convictions that are unspent under the Rehabilitation of Offenders Act 1974, please let us know and provide details below. Please note that some posts are exempt from the Rehabilitation of Offenders Act 1974 as they involve working with vulnerable adults and will require a Disclosure and Barring Service (DBS) check. If you have applied for an exempt post, please supply details below.
I do not have any unspent criminal convictions
I am applying for an exempt post and understand that a DBS check will be carried out if I am successful in my appointment
I have an unspent criminal conviction (please supply details below)

References

Please give the names and contact details of two referees. One referee should be your
present or most recent employer. References will not be taken up until an offer of employment
has been made.


Referee 1
Referee 2

Other Factors

Please use this space if you would like to tell us about any way in which Dorset Mind could
support you to apply for the post, for example by providing alternative versions of the
information provided, assistance with attending the interview or any other adjustments.

Declaration

I confirm that to the best of my knowledge all information I have given in my application is correct and can be treated as part of any subsequent contract of employment. Any false, deliberate omission, or misleading information may be sufficient cause for rejection or, if employed by Dorset
Mind, to be dismissed.

I agree Dorset Mind can approach any of my previous employers for a reference to confirm that any information given in relation to my application is correct.

I consent to Dorset Mind storing and processing my application in line with their policies and procedures and in line with the Data Protection Legislation.

Please tick this box to confirm

Current Employer

Previous Employers

Education

Please give details of your educational qualifications and training. You may be required to provide proof of qualifications and training courses.

Other Training including Continued Professional Development

Are you a member of a professional body or organisation?

Residency

Have you lived outside the UK at any time for a period longer than 6 months?
Yes
No

Suitability for the post

Other Employment

Yes
No

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