New Application

What position are you applying for?

1. Personal Information

Please fill out all sections

Title

First Name

Middle Name

Last Name

Phone/Mobile

Address

Address Line 1

Address Line 2

City

Postcode

Date of Birth

Gender

Country of Birth

Nationality

National Insurance Number

Mothers Maiden Name

Your Photo

You can use your smartphone to take a photo or upload an existing one.

Choose Photo or Take Photo

2. Academic Qualifications

Please list any qualifications below, you may list up to 3.

Institute/Place of Study

Dates: (to & from)

List Qualifications

Add more qualifications

Add

Institute/Place of Study

Dates: (to & from)

List Qualifications

Add more qualifications

Add

Institute/Place of Study

Dates: (to & from)

List Qualifications

3. Current Employment Information

Company Name

Your current position

Address for Current Employer

Address Line 1

Address Line 2

City

Postcode

Managers Name

Managers Contact Number

Start Date

End Date (if applicable)

Reason for leaving

4. 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.

Company Name (1)

Your position

Address

Address Line 1

Address Line 2

City

Postcode

Start Date

End Date

Reason for leaving

Add another employer

Add

Company Name (2)

Your position

Address

Address Line 1

Address Line 2

City

Postcode

Start Date

End Date

Reason for leaving

Add another employer

Add

Company Name (3)

Your position

Address

Address Line 1

Address Line 2

City

Postcode

Start Date

End Date

Reason for leaving

Add another employer

Add

Company Name (4)

Your position

Address

Address Line 1

Address Line 2

City

Postcode

Start Date

End Date

Reason for leaving

5. Community, Volunteer or Intern Experience

You can add up to 3

Name of Organisation or Company

Position Held

General Duties

Start Date

End Date

Add more

Add

Name of Organisation or Company

Position Held

General Duties

Start Date

End Date

Add more

Add

Name of Organisation or Company

Position Held

General Duties

Start Date

End Date

6. Permission to work in the UK

Do you have permission to work in the UK?

Yes

Are there any work restrictions on your UK visa?

Yes

7. Registered Nurse NMC Pin

(if applicable)

NMC Number

NMC Pin

Upload a copy of your NMC Certificate

Choose File

8. Proof of Professional Indemnity Insurance

(if applicable)

Can you provide evidence of Professional Indemnity Insurance?

Yes

9. Skills & Experience

In support of your application, please detail your relevant skills, experiences and personal qualities which you believe are relevant to the position you're applying fo

List skills and experience below:

10. 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 Nursing 247 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

Full Name

Job Title

Company Name & Address

Contact Number

Add 2nd referee

Add

Referee 2

Full Name

Job Title

Company Name & Address

Contact Number

Add 3rd referee

Add

Referee 3

Full Name

Job Title

Company Name & Address

Contact Number

11. Next of Kin Details

Who would you like us to contact in an event of an emergency?

Full Name

Relationship

Address

Address Line 1

Address Line 2

City

Postcode

Contact Number

Work Number

12. Criminal Records

Do you have any criminal convictions/ cautions or bind overs in the UK or abroad? (at work or in public life):

Yes

Please detail below:

Are you / have you been under / or undergoing any clinical investigation, disciplinary or suspension process pending or otherwise?

Yes

If yes, please detail below:

This employment is not exempt from the provisions of the rehabilitation of young offenders Act 1974, you are not therefore entitled to withhold information requested by the company about any previous convictions in this country or abroad you may have, even if in other circumstances these would appear spent. I confirm that the information I have given is true. I understand that if information given on the application form is found to be false it may result in disciplinary action which could include dismissal. Should I be offered employment, I accept that I will be required to notify the company of any changes to my DBS status.

Your signature will be required to confirm the above statement.

Sign Here

Print Name

Date / Time

13. Covid Vaccination

Have you has BOTH of your Covid-19 vaccinations?

Yes

First Vaccine Date

Second Vaccine Date

Date of last Negative PCR Test

Upload your NHS Proof of Vaccine and latest Negative PCR Test proof here:

Upload All Files Here

14. 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.

Where did you hear about us?

15. Required Documents

We require the following documents, you can upload them below. You can use your phone camera to take a photo if you are filling the form on your phone.

If you do not have these at hand, you can email or whatsapp them to our admin team later.

Our team will be in touch to collect any missing documents.

Valid Passport (page with your photo, please make sure all parts are visible)

Choose File

Visa Document (if applicable)

Choose File

Proof of Address (Bank Statement, Utility Bill or Gov Document)

Choose File

DBS Certificate (all parts)

Choose File

Certificate of Mandatory Training

Choose File

Your latest CV

Choose File

Employment with Universal Nursing 24/7

It is Universal Nursing 24/7 policy to employ the most suitably qualified personnel and to ensure equal opportunity for the advancement of employee. This includes promotion and training and to prohibit discrimination against any individual on the basis of race, colour, ethnicity, nationality, sexual orientation, gender, religion, belief, pregnancy, marital or civil partnership status, age or disability. In completion of this application form, I authorise Universal Nursing 24/7 to obtain references to support this application once an offer has been made and accepted. I release Universal Nursing 24/7 and submitted referees from any liability caused by giving and receiving any information. I confirm that the information given on this form is to the best of my knowledge, true and complete and that the provision of any false statement(s) will be sufficient cause for rejection or if employed, dismissal.

I have read and understood the terms and conditions.

Yes

Signature

Sign Here

Print Name

Date

1. Personal Information

Your Photo

2. Academic Qualifications

3. Current Employment Information

4. Full Employment History including any gaps

5. Community, Volunteer or Intern Experience

6. Permission to work in the UK

7. Registered Nurse NMC Pin

8. Proof of Professional Indemnity Insurance

9. Skills & Experience

10. Professional References

Referee 1

Referee 2

Referee 3

11. Next of Kin Details

12. Criminal Records

13. Covid Vaccination

14. Working Time Regulations 1998

15. Required Documents

Employment with Universal Nursing 24/7

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