APPLICATION FORM


Personal Information







Full Employment History including any gaps

Please note a full 10 year employment history must be provided, or your employment history since leaving full time education if less than 10 years. All gaps over 2 months in employment history must be detailed with a note of explanation.







yes







yes








yes







yes







yes






Permissions to work in the UK

YesNo

YesNo

NMC Pin (if applicable)




Professional References

Please provide full names and addresses of two professional employment referees and one character referee. Your first reference must be from your current or previous last place of work and addressed to your line manager. Universal Care & Nursing 24/7 cannot use friends or relatives for any employment references. Employment references cannot be sent to private or personal home addresses. You must provide workplace addresses and the referee must be a higher grade of staff than you yourself i.e. your line manager

REFEREE 1



















REFEREE 2
















Criminal Records

YesNo


YesNo


Working Time Regulations 1998

The European Union has laid down guidelines for all workers, governing the length of the maximum working week that is safe to work. The current limit is 48 hours per week. Because you are under no obligation to accept work offered, you will not be compelled to work more than 48 hours per week, however you may choose to do so.

Please select the appropriate option to confirm that you have read and understood the above information.

yes