APPLY ONLINE

Please take a moment to fill in this form, taking care not to miss any required fields, which are indicated with an asterisk ( * ). When you have finished, click the 'Submit' button located at the bottom of this page to complete the application process.

Or if you prefer, you may UPLOAD YOUR CV here.

Title    
* Surname * Forenames
* Date of Birth    
 
* Address    
     
* Town / City * Postcode  
* E-mail    Address      
 
* Home    Telephone Mobile No.
* Nationality * National    Insurance No.
 
Do You Require a Work Permit? Yes: No:
* Preferred Area of Work (Town / City)?
* What Form of Transport Do you Use?
Next of Kin
* Forenames * Surname
 
* Address    
     
* Town / City * Postcode  
* Telephone    No.      
College of Health Studies
Name & Address of College of Health Studies
   
 
Courses e.g RN1, HV, Nurse prescribing etc. Date Obtained  
 
 
 
 
 
 
NMC Reg. No. Expiry Date
 
ENB Courses Held Year Obtained  
 
 
 
 
Employment History
Previous 15 Years employment history as a minimum where possible.
Name & Address of Employer Position / Grade From To
References
These must be from your 2 most recent work assignments. You must include the name of referee, Position, e-mail address where ever possible. The referees should correlate with your previously provided work history.
   
Additional Information
Please enter your specialty and any other relevant information.
   

Further Documentation Required to be Provided at interview:

  • NMC Card
  • Statement of entry
  • Passport
  • Proof of Address
  • Passport picture x 2
  • Driving License where applicable
  • CRB original copy if within 6 months

Full vaccination history including:

  • Hep B
  • Hep C
  • Varicella
  • Rubella
  • BCG
  • Polio