Job Application Form

Please read our GDPR Policy and Procedure before completing the form to understand why we ask for your data, what we do with it and how we keep it safe.

    Personal Details

    Home Address

    Employment History

    Please give details of your FULL employment history in date order starting with the most recent. You must include ALL employment, career breaks and periods of unemployment, education and volunteer work since leaving secondary education; any gaps must be explained to comply with auditing requirements.


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    Training And Qualifications

    Please provide details about your training and qualifications. Relevant qualifications must be supported by certificates at interview.

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    Supporting Statement *

    In a maximum of 200 words, please tell us how you would be excellent in the role you have applied for.


    Please provide details of two referees. These must be your previous two employers if you have been in employment or your tutor if you have been in education. Any other person can provide a character reference if you do not have two previous employers. These cannot be your partner or a member of your family.

    Declaration And Consent

    Right to work in the United Kingdom

    In order to comply with the immigration, Asylum and Nationality Act 2006 we will ask you to provide documentary evidence of your right to work in the UK during the recruitment process.

    The Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 removes the normal operation of the Act in relation to specific occupations, including the provision of Home Care Services. The nature of this work means you need to provide information about any criminal record you have, spent or unspent and includes cautions, reprimands and warnings. This appointment is subject to a satisfactory enhanced disclosure from the Disclosure and Barring Service (DBS). This check will also show whether a person is barred from working with vulnerable adults and children. In the event of being employed in connection with this application, any failure to disclose such convictions could result in dismissal or disciplinary action. The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are ‘protected’ and are not subject to disclosure to employers, and cannot be taken into account. Guidance on criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website.

    If you do have any previous or outstanding convictions, cautions, reprimands or warnings that are
    not “protected”, you will only be asked to supply details if you are invited for interview. You will need to give written details of the offence, the penalty and dates. This should be put in a sealed envelope and sent in advance of the interview to the HR Manager. There will be a discussion about any offences or other matters that might be relevant to the position. Having a criminal record will
    not necessarily bar you from working at Crossroads Care. This will depend upon the nature of the position and the circumstances and background of your offences.

    Do you have any convictions, cautions, reprimands or final warnings that are not ‘protected’ as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)?

    Please tick the following boxes
    I declare that the information on this application form is true and accurate, to the best of my knowledge. Please note that if you give untrue or inaccurate information any employment contract may be invalidated and the employee subject to disciplinary action or dismissal.

    I hereby give permission for Crossroads Care, Hertfordshire North to access my DBS online certificate.

    Please insert your name below as a declaration and consent

    Find a rewarding career with Crossroads

    Discover more about joining our team
    please contact our People Services Team on  01462 427019 or

    Find a rewarding career with Crossroads

    Discover more about joining our team
    please contact us
    on 01462 455578