Job Application Form

BS24 GROUP Job application

ONLY SHORTLISTED ARE CONTACTED TO PROGRESS
Application form

STRICTLY CONFIDENTIAL when completed
Position applied for
Maiden/ Former Name

TitleFirst NameMiddle NameLast Name
Current Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Five years address if different from above.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mobile number*
Home telephone number*
National Insurance Number
Birth Date*

MonthDayYear
Nationality
Marital Status
E-mail*
Do you hold a UK full/ provisional driving licence?*

YesNo
Expiry date

MonthDayYear
Are you subject to immigration control (do you need a work visa)*

YesNo
If yes, do you have an unrestricted entitlement to take up employment in the UK?*

YesNo
Do you hold a registration Nurse Pin certificate?*

YesNo
MMC Pin No
Expiry date

MonthDayYear
Have you ever been fined, sentenced to imprisonment or placed on probation for a criminal act (subject to the Rehabilitation of Offenders Act)?*

YesNo
Are there any alleged offences outstanding against you?*

YesNo
If Yes, give details
Have you ever been made bankrupt or have any Court Judgements against you, whether satisfied or not, within the last 6 years?*

YesNo
Application form (Continued)
EMPLOYMENT 5 YEARS RECORD

Starting with your last or present employer, give details of your employment history for the last 5 years, including details full time education if it falls within that period. Include periods of self-employment and military service. For any periods of unemployment give the address of the DWP Office to which you reported or the name of a person (not a relative) who can confirm your whereabouts
Current Employer
Employer name 1
Name of Current Employer or NONE if not Employed
Position held
Your job role
Reporting to
Reason for leaving
Tel:
Fax:
Start Date

MonthDayYear
End Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reference email as consent to obtain reference.*
Email Of Current Employer or NONE if not Employed
Other Employers
Employer 2
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reason for leaving
Start Date

MonthDayYear
End Date

MonthDayYear
Email
Reason for leaving
Education
Highest Level of Education
Name of current school/ college/ university
Previous Institution
List your name of school/ college attended and YEAR
Skills/Qualifications:
Relevant Skills
List any relevant skills to your job application
Qualifications
List any relevant certifications or qualifications you have already obtained
References
Character reference (Personal)

Give the name and address of at least one person, who has known you well for at least two years, is still in contact with you and who will provide a written reference. This person should have known you for at least two years and not to be a previous employer, relative or resident at the same address as yourself.
Reference 1*
Name of Reference
Relationship*
Years Acquainted
Email*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone
Occupation
Authorization and Compliance
DECLARATIONS

I certify that to the best of my knowledge, the information that I have given in my application for the employment is true and complete and understand that any false statement or omission to the Company or its representatives may render lead to termination of employment or unemployment. I authorize the Company or its agents to approach Government agencies, former employers, educational establishments, criminal justice agencies and personal referees for information relating to and verification of my employment/unemployment record. I consent to the Company’s reasonable processing of any personal information obtained for the purpose of establishing my medical condition and future fitness to perform my duties. I accept that I may be required to undergo a medical examination where requested by the Company. Subject to the Access to Medical Reports Act 1988, I consent to the results of such examination to be given to the Company and authorize the Company to make a consumer information search with a credit reference agencies. I further declare that any documents that I provide as proof of my identity, proof of address, proof of right to work and any other documents that I provide are genuine and give my consent for these documents may be reported to the appropriate authority.

DATA PROTECTION ACT 1998

The Company will use the information you have given on your application form (together with any information which we obtain with your consent from third parties) for assessing your suitability for employment. It may be necessary to disclose your information to our agents and other service providers.

By returning this form to the Company you consent to our processing personal data about you where this is necessary, for example information about your credit status, ethnic origin or criminal offences. You also consent to the transfer of your information to your current and future potential employers where this is necessary (this may be to companies operating abroard if you apply for work outside of the United Kingdom).

Your information will be held on our computer database and/ or in our paper filing systems. By signing below you agree to this process and confirm that you do not have a criminal record subject to the current Rehabilitation of Offenders Act and any amendments. You have the right to apply for a copy of your information (for which we may charge a small fee) and to have any inaccuracies corrected.

DISCLOSURE

You are applying for a position of trust and in the event of being offered employment by the Company we may apply for a Disclosure. However, having a criminal record does not necessarily bar you from employment. For more information ask a member of staff for a copy of the CRB Code of Practice/Disclosure Scotland and/or Company our policy statement regarding ex-offenders. Disclosure information is treated in a sensitive way and is restricted to those who need to see it to make a recruitment decision. By signing this document you allow the company to see a copy of the Disclosure. The Disclosure information is not retained i.e. it is disposed of within the timescales recommended in the CRB Code of Practice. By signing below you agree to this process.

SCREENING

Any offer of employment is subject to satisfactory screening, that the applicant consents to being screened and will provide information as required. That the information provided is correct, and the applicant acknowledges that any false statements or omissions could lead to termination of employment.
Applicant name*
Write full name in BLOCK letters
Date*

MonthDayYear
Next of kin
Name*

TitleFirst NameLast Name
Relationship e.g Spouse / Parent / family etc*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mobile number*
Applicants Bank details
UK Bank name
e.g. Barclays, Llyods, etc
Printed name
Name on your bank card
Sort code
Account number
Risks identified during the consumer information search are to be signed-off. An executive of the organisation, having reviewed the documentation evidence, may sign-off the security screening file.
Cover Letter & Resume (Optional)

Bring a copy of your CV
Send Application:
By clicking the submit button below, I certify that all of the information provided by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option.

I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company.
Take Photo
Once submitted, scroll back to the top of the page to continue with the application process.
Should be Empty:

BS24 GROUP Job application

Application form

Application form (Continued)

Current Employer

Other Employers

Education

Skills/Qualifications:

References

Authorization and Compliance

Next of kin

Applicants Bank details

Cover Letter & Resume (Optional)

Send Application: