Application Form

Important Documents

Please note that only the information given in this application form will be considered in determining whether or not you will be called for interview. You MUST complete all sections. Please specifically address the criteria detailed in the Person Specification.


Personal Details

Education, Training and Development

If the post requires specific qualifications you will be required to provide documentary evidence

Present or Last Employer

Previous Employment and Experience


Please give the name and address of two referees, one of whom should be your current or most recent employer, who can comment on your suitability for this post. If you were known by a different name, please also state this. PLEASE NOTE THAT, DUE TO SAFEGUARDING REASONS, REFERENCES WILL BE TAKEN UP PRIOR TO INTERVIEW IF YOU ARE SHORTLISTED.

Referee 1

Referee 2

Supporting Information


I declare that the information I have given on this form is correct and complete. False or misleading statements may be sufficient grounds for cancelling any agreements made, or for disciplinary action to be commenced.

Declaration of Criminal Background Information

All applicants must complete the following questions in full as part of their application.

*If any circumstances change which would affect your response to this question, you must inform the Human Resources department of the details without unnecessary delay.

Have you ever been disqualified from work with children or vulnerable adults or subject to any other sanctions imposed by a regulatory body?

Are you registered with the Disclosure and Barring Service (DBS) Update Service?


Please sign the following declaration and as it forms part of your application. Failure to complete this declaration will result in your application not being processed.

I confirm that the information I have given on this form is correct and complete and I understand that any false information could result in my application being rejected or, if appointed, in my dismissal from employment. I understand that any offer of employment made to me will be subject to a further check with the Disclosure and Barring Service (previously Criminal Records Bureau) and I hereby give my consent for Coram to carry out the relevant DBS status checks in line with the DBS Code of Practice.

I declare that I am not currently on the DBS Barred List and that I will notify the Human Resources department immediately if I do become barred in future.

If you would like to fill out an optional Diversity Monitoring Form, please click here.