APPLICATION PACK GUIDANCE TO HELP YOU MAKE YOUR APPLICATION (2 PAGES) APPLICATION FORM (5 PAGES) EQUAL OPPORTUNITIES (2 PAGES)

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APPLICATION PACK PLEASE FIND FOLLOWING: GUIDANCE TO HELP YOU MAKE YOUR APPLICATION (2 PAGES) APPLICATION FORM (5 PAGES) EQUAL OPPORTUNITIES (2 PAGES) PLEASE DO NOT COMPLETE THE DOWNLOADED APPLICATION FORM IN MICROSOFT WORD AS IT UPSETS THE PAGE FORMATTING. PLEASE PRINT OFF THE BLANK FORM AND COMPLETE BY HAND.

DAVIGDOR LODGE REST HOME MENTAL HEALTH GUIDANCE TO HELP YOU WHEN MAKING YOUR APPLICATION These guidance notes are designed to assist you in completing your application. All information you write is confidential. The decision to shortlist you for interview will be based solely on the information you provide on your form so it is important that you complete the form as accurately and as fully as possible. Please complete the form in black ink or type, as it will be necessary to photocopy your application form. If you also wish to include a CV, we recommend that this should be a maximum of three sheets of A4. Personal Details Please complete this section in Block Capitals, clearly, and in full where possible. We may need to contact outside parties with regards to your application, such as the Disclosure and Barring Service (DBS) to perform a CRB/DBS check. If the personal information used is inaccurate and/or incomplete, this may delay processing your application. Please will you also include your e-mail address and that of your referees if appropriate? Please kindly inform your referees that they will be contacted for a reference. As sometimes a reply is needed before the interview date if you are shortlisted. Job Description The Job Description outlines the main purpose and duties of the job. This also identifies experience and skills, which are necessary for the job and the criteria against which you will be selected for interview. Education, Training and Qualifications Make sure you give all the information needed, including dates of study, making clear the level of examinations e.g. GCSE, GCE, O Level or A Level etc., and the grades obtained. Also include any special skills training; short courses or relevant work placements. References Your principal referee should be your present employer/tutor. A second referee is required from somebody who can testify as to your suitability for the type of employment for which you have applied e.g. past employer/tutor. Both referees will be contacted before interviews take place, unless you clearly state otherwise. We are unable to accept references from friends or colleagues. Employment History Write here the name and full address of your present and past employers and the dates you were employed by them. Please give a full career history including any temporary, part-time, or voluntary/unpaid work. Please give reasons for any gaps in employment.

Additional Information This is the most important section. You should explain your reasons for making this application and your interest in this area of work. You must demonstrate how you meet each of the criterion identified in the Person Specification, drawing on your past experience and highlighting the skills you have gained and developed as a result. These should then be put into context by providing specific examples. Include any activities outside of work that may be relevant e.g. voluntary, community or charity work, leisure interests, membership of professional/other organisations or caring for relations. If you use additional sheets, please number them clearly and print your name at the top of each sheet remember to sign the form. To be considered for this post your completed application form must be received at Davigdor Lodge by 5pm on the closing date. If you have not heard from us within 4 weeks of the closing date, this would indicate that your application has been unsuccessful on this occasion. However, you are most welcome to apply for future advertised positions within Davigdor Lodge. IF YOU REQUIRE ANY FURTHER ASSISTANCE YOU CAN CONTACT: - Davigdor Lodge, FAO Manager, 56-58 Tisbury Road, Hove, East Sussex, BN3 3BB Email: manager@davigdorlodge.co.uk Tel: 01273 726868 We look forward to receiving your completed application.

DAVIGDOR LODGE REST HOME MENTAL HEALTH IN CONFIDENCE Position Applied for: Please Return To: Davigdor Lodge, FAO Manager 56-58 Tisbury Road Hove, East Sussex, BN3 3BB PERSONAL DETAILS Mr Mrs Ms Miss Dr Surname Forename s Current Address Date moved in to current address (MM/YYYY) Telephone No. (home) Mobile Number E-mail Telephone No. (work) Date of birth Do you possess a valid & current driving license? Yes No NI Number REFERENCES Please give the names and full addresses of two referees. These should include your present employer or last employer if currently unemployed. Students should give the names of head teacher, tutor or Professor as appropriate. We are unable to accept references from friends or colleagues. Title Title Name Address Name Address E-mail Tel. No. Relationship to applicant Tel. No. E-mail Relationship to applicant May we approach the above, May we approach the above Prior to interview? Yes No Prior to interview? Yes No

ADDRESS HISTORY Please give details of your address history for the last 5 years. If applicable, please include any addresses outside the United Kingdom. This information is required for us to complete a Disclosure Barring Service (DBS) or CRB check. Please include the most recent address first, and continue in descending order. If there is insufficient room on the form to include the necessary addresses, please complete on a separate piece of paper and attach to the form. Past Address 1 Address Line 1 Address Line 2 Town/City County / District Post Code/Zip Country Date From (MM/YYYY) Date To (MM/YYYY) Past Address 2 Address Line 1 Address Line 2 Town/City County / District Post Code/Zip Country Date From (MM/YYYY) Date To (MM/YYYY) Past Address 3 Address Line 1 Address Line 2 Town/City County / District Post Code/Zip Country Date From (MM/YYYY) Date To (MM/YYYY)

EDUCATION TRAINING AND QUALIFICATIONS Secondary Education Place of education From To Subject Education Results Level Grade Date Further Education Place of education From To Subject Education Results Level Grade Date Professional Name of Professional Body Membership Grade and/or Registration & Pin No. How gained Full/Part Time Date Training please include any short course or relevant in-service training From To Course/Subject Qualifications

EMPLOYMENT HISTORY Please give career history including any periods of voluntary/unpaid work and reasons for any gaps in employment. Name and full address of present or most recent employer Job Title Salary/Grade From To Reason for leaving Names of previous employers and nature of business (Starting with the most recent) Position Held From To Reason for Leaving

ADDITIONAL INFORMATION Drawing on your experiences/skills/abilities and qualifications, please demonstrate how you meet the Person Specification and explain what makes you suitable for this position. Address each criterion in turn. Include details of any relevant unpaid or voluntary work (see Guidance Notes). Continue on a separate sheet if necessary. DISCLOSURE OF INFORMATION Because of 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 Act (Exceptions) Order 1973. Applicants are, therefore, not entitled to withhold information about convictions which, for other purposes, are 'spent' under the provisions of the Act, and in the event of employment, any failure to disclose such convictions could result in dismissal or disciplinary action by Davigdor Lodge. Any information given will be completely confidential and will be considered only in relation to posts to which the order applies. Do you have any convictions to disclose? If YES, please give details: Are there any proceedings currently being investigated against you? If YES, please give details: DECLARATION I understand that all appointments are subject to medical clearance and satisfactory references. If successful, I agree to a Criminals Records Bureau check at the appropriate level for this post. I certify that the information contained in the application is correct and understand that failure to disclose any information could result in termination of my contract, should I be successful in this application. Signature Date

DAVIGDOR LODGE REST HOME MENTAL HEALTH EQUAL OPPORTUNITIES RECRUITMENT MONITORING Davigdor Lodge is actively seeking to recruit people currently under represented in the workforce. This includes people from ethnic minorities and people who have experienced mental health problems. In order to help us monitor the effectiveness of our policy, please complete this form. The information will be used solely for monitoring purposes and treated as strictly confidential. It will be separated from your application form before any consideration of candidates takes place. Any complaints that applications for employment have been unfairly considered may be made in writing to the manager at Davigdor Lodge. Please tick relevant box Mr Mrs Ms Miss Dr Sex: Male Female Marital Status Surname Forenames CHILDREN AND DEPENDENTS The Equal Opportunities Commission recommends that information on children and dependents should be collected on monitoring forms, to ensure that there is no discrimination against applicants with dependents. Number of children Age 0-4 years 5 16 years Other dependants (please specify) ETHNIC ORIGIN: Please tick the category which you feel best describes your ethnic origin: WHITE British Irish Any Other White Background MIXED White and Black Caribbean White and Black African White and Asian Any other Mixed Background BLACK OR BLACK BRITISH Caribbean African Any Other Black Background ASIAN OR ASIAN BRITISH Indian Pakistani Bangladeshi Any Other Asian Background OTHER ETHNIC GROUPS Chinese Any Other Ethnic Groups Not Stated

CITIZENSHIP If you are not a British Citizen or European Community National, is there any restriction placed on the length of time that you may stay in the United Kingdom? Yes No Do you require a work permit? Yes No N/A If you answer yes to either question please specify. Give details on a separate sheet and attach it to your application DISABILITY Do you have a disability that you wish to tell us about? Yes No N/A Please use this space for any comments: MENTAL HEALTH Please tick the appropriate box to indicate what mental health problems you have experienced. None Problems treated solely via primary care services, at GP surgery, in private counselling/psychotherapy or through self help support Referred to psychiatric services for out-patient or in-patient treatment. Please use this space for any comments: DISCLOSURE OF INFORMATION Are you related to a Director or a senior employee of this organisation? Yes No RECRUITMENT PUBLICITY From what source did you learn about this vacancy? What did you think about the quality of the recruitment information you received? Excellent Good Fair No comment Please use the space for any comments: