RM_Stats

Personal Details

Title^*

First Name^*

Middle Name

Last Name^*

Previous Name (If Applicable)

Email^*

Username^*

Password^*

Password must be at least 7 characters long.

Enter password again^*

Password must be at least 7 characters long.

Date of Birth^*

Profile Picture

Your Address

Address Line 1^*

City^*

Post Code

Enter Your Country^*

Further Personal Details

Mobile Number^*

Home Phone Number

What Position are you applying for?^*

Nurse
Healthcare Assistant
Support Worker
Other

Passport and NMC Details (for Workers from Overseas)

NMC Pin Number

NMC Pin Expiry Date

Tick Membership

Membership Number

Membership Expiry Date

Passport Nationality^*

Place of Issue^*

Date of Issue^*

Passport Expiry Date^*

Known restrictions in use

NMC Test

NMC Test Of Competence^*

NMC Test Date Taken

Attach NMC Test Results (If Applicable)

English Language Test (IELTS)

All applicants must meet English language requirements, with an International English Language Test (IELTS) score of 7.0.

Any English Language Test (IELTS) taken more than 2 years ago will be invalid and candidates will have to retake this exam.

English Language Test Result: Grade

English Language Test Date Taken

Upload IELTS

Adult General Nursing: Grade

Adult General Nursing: Date Taken

Children's Nursing: Grade

Children's Nursing: Date Taken

Learning Disability Nursing: Grade

Learning Disability Nursing: Date Taken

Mental Health Nursing: Grade

Mental Health Nursing: Date Taken

Midwifery: Grade

Midwifery: Date Taken

Upload Nurse Aid Training

Upload your O'Level Certificate

Upload TB Tests

Upload Police Clearance

CV and Transcript

Attach Transcript Obtained (If Applicable)

Attach Your CV

Vocational Qualifications/ Courses Attended

Would you like to add your qualifications?^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Would you like to add more your qualifications?^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Would you like to add more your qualifications?.^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Would you like to add more your qualifications?..^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Work Experience

Please print details of all your employment history for a period of at least the last 5 years, in reverse date order, starting with your present or last position.

Current / Most Recent Employer

Position Held

Duties Performed

Reason for Leaving

Date From

Date To

Employer Address

Would you like to add another previous employment details?^*

Employer Name^*

Position Held^*

Duties Performed^*

Reason for Leaving^*

Date From^*

Date To^*

Employer Address^*

Would you like to add another previous employment details?.^*

Employer Name^*

Position Held^*

Duties Performed^*

Reason for Leaving^*

Date From^*

Date To^*

Employer Address^*

General Information

Do you have a driving License?^*

Please state which language you speak, including an indication of fluency^*

How did you first hear about Evantu Recruitment

References

Please give the names and addresses of 2 professional referees, whom we may approach for a reference.

Both referees must have known you in a professional capacity (Not relatives or friends) and one should be your present or most recent employer.

1st Referee:

Organisation Name^*

Contact Name^*

Telephone^*

Organisation Address^*

Email^*

This is my^*

Length of time known^*

2nd Referee:

Organisation Name^*

Contact Name^*

Telephone^*

Organisation Address^*

Email^*

This is my^*

Length of time known^*

Next of Kin Details

Title^*

Surname^*

First Name^*

Email Address

Telephone

Mobile Number^*

Address^*

Relationship^*

Confidentiality Declaration

Confidentiality Declaration^*

Registration implies acceptance of our codes of confidentiality. In the course of your duties you may have access to confidential information about your client. On No account must information relating to identifiable clients be divulged to anyone other than your branch manager or his/her assistant. You should Not disclose any information to your family, friends, neighbours etc... If you are worried by any information you have obtained and consider that you should talk about it to someone else make an appointment to speak in private to your superior/supervisor/manager. Failure to observe these rules will be regarded as serious misconduct which will result in the removal from the agency register.

I have read and I understand the above and I agree to abide by the contents therein.

Signature^*

Date^*

Enhanced Criminal Records Disclosure Information Sheet

Under the rehabilitation of Offenders Act 1974 you are required to reveal ALL convictions. This has to include ALL spent convictions as defined under the act.

We actively promote equality of opportunity for all, as stated in our Equal Opportunities policy, which can be found in your handbook or at your local office. If you are in any doubt whatsoever about a declaration, you must discuss this with your local office manager.

A conviction does not automatically prevent you from registering, however failure to declare, will lead to immediate action. You are required to inform us if you are convicted of a criminal offence, cautioned or have a hearing pending in the future.

What is an enhanced disclosure?

An enhanced disclosure is for positions involving greater contact with Children or vulnerable adults. In addition to the information provided on a standard disclosure, the enhanced disclosure involves an additional check with the police, who check if any information is held on file that may be relevant. The police decide what (if any) additional information will be added to the disclosure.

In rare circumstances the police may write to the employer separately giving confidential information about an ongoing criminal investigation into the applicant. This information may NOT be released to the applicant.

Examples of information that may not be released:

All spent convictions (from childhood up until present day)
Investigations that have not led to a criminal conviction
Any action taken against you by a local authority
Driving offences received through a court of law
Details of ongoing criminal investigations

If an offence is highlighted (when we receive your enhanced disclosure) that you have not declared your application may be withdrawn from the recruitment process.

For more information on CRB enhanced disclosures please call 0870 9090811 or visit their web site www.crb.gov.uk.

Declaration

The information supplied on this form will be processed and stored in manual and computerised records for recruitment employment and management processes. You have the right to access this data. All information will be treated in the strictest confidence. Unsuccessful applicants will be retained for 3 months.

I declare that the information contained on this form is true and complete. I understand that if it is later discovered that any statement is false or misleading, it may be sufficient for cancelling any agreements made or I may be dismissed from employment by the company.

I consent to Evantu Recruitment holding and processing this information and give permission for reference checking in connection with my application. I understand too that an Enhanced Criminal Record Bureau Disclosure will be sought.

Signature^*

Date^*

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RM_Stats

Personal Details

Title^*

First Name^*

Middle Name

Last Name^*

Previous Name (If Applicable)

Email^*

Username^*

Password^*

Password must be at least 7 characters long.

Enter password again^*

Password must be at least 7 characters long.

Date of Birth^*

Profile Picture

Your Address

Address Line 1^*

City^*

Post Code

Enter Your Country^*

Further Personal Details

Mobile Number^*

Home Phone Number

What Position are you applying for?^*

Nurse
Healthcare Assistant
Support Worker
Other

Passport and NMC Details (for Workers from Overseas)

NMC Pin Number

NMC Pin Expiry Date

Tick Membership

Membership Number

Membership Expiry Date

Passport Nationality^*

Place of Issue^*

Date of Issue^*

Passport Expiry Date^*

Known restrictions in use

NMC Test

NMC Test Of Competence^*

NMC Test Date Taken

Attach NMC Test Results (If Applicable)

English Language Test (IELTS)

All applicants must meet English language requirements, with an International English Language Test (IELTS) score of 7.0.

Any English Language Test (IELTS) taken more than 2 years ago will be invalid and candidates will have to retake this exam.

English Language Test Result: Grade

English Language Test Date Taken

Upload IELTS

Adult General Nursing: Grade

Adult General Nursing: Date Taken

Children's Nursing: Grade

Children's Nursing: Date Taken

Learning Disability Nursing: Grade

Learning Disability Nursing: Date Taken

Mental Health Nursing: Grade

Mental Health Nursing: Date Taken

Midwifery: Grade

Midwifery: Date Taken

Upload Nurse Aid Training

Upload your O'Level Certificate

Upload TB Tests

Upload Police Clearance

CV and Transcript

Attach Transcript Obtained (If Applicable)

Attach Your CV

Vocational Qualifications/ Courses Attended

Would you like to add your qualifications?^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Would you like to add more your qualifications?^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Would you like to add more your qualifications?.^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Would you like to add more your qualifications?..^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Work Experience

Please print details of all your employment history for a period of at least the last 5 years, in reverse date order, starting with your present or last position.

Current / Most Recent Employer

Position Held

Duties Performed

Reason for Leaving

Date From

Date To

Employer Address

Would you like to add another previous employment details?^*

Employer Name^*

Position Held^*

Duties Performed^*

Reason for Leaving^*

Date From^*

Date To^*

Employer Address^*

Would you like to add another previous employment details?.^*

Employer Name^*

Position Held^*

Duties Performed^*

Reason for Leaving^*

Date From^*

Date To^*

Employer Address^*

General Information

Do you have a driving License?^*

Please state which language you speak, including an indication of fluency^*

How did you first hear about Evantu Recruitment

References

Please give the names and addresses of 2 professional referees, whom we may approach for a reference.

Both referees must have known you in a professional capacity (Not relatives or friends) and one should be your present or most recent employer.

1st Referee:

Organisation Name^*

Contact Name^*

Telephone^*

Organisation Address^*

Email^*

This is my^*

Length of time known^*

2nd Referee:

Organisation Name^*

Contact Name^*

Telephone^*

Organisation Address^*

Email^*

This is my^*

Length of time known^*

Next of Kin Details

Title^*

Surname^*

First Name^*

Email Address

Telephone

Mobile Number^*

Address^*

Relationship^*

Confidentiality Declaration

Confidentiality Declaration^*

Registration implies acceptance of our codes of confidentiality. In the course of your duties you may have access to confidential information about your client. On No account must information relating to identifiable clients be divulged to anyone other than your branch manager or his/her assistant. You should Not disclose any information to your family, friends, neighbours etc... If you are worried by any information you have obtained and consider that you should talk about it to someone else make an appointment to speak in private to your superior/supervisor/manager. Failure to observe these rules will be regarded as serious misconduct which will result in the removal from the agency register.

I have read and I understand the above and I agree to abide by the contents therein.

Signature^*

Date^*

Enhanced Criminal Records Disclosure Information Sheet

Under the rehabilitation of Offenders Act 1974 you are required to reveal ALL convictions. This has to include ALL spent convictions as defined under the act.

What is an enhanced disclosure?

Examples of information that may not be released:

All spent convictions (from childhood up until present day)
Investigations that have not led to a criminal conviction
Any action taken against you by a local authority
Driving offences received through a court of law
Details of ongoing criminal investigations

If an offence is highlighted (when we receive your enhanced disclosure) that you have not declared your application may be withdrawn from the recruitment process.

For more information on CRB enhanced disclosures please call 0870 9090811 or visit their web site www.crb.gov.uk.

Declaration

The information supplied on this form will be processed and stored in manual and computerised records for recruitment employment and management processes. You have the right to access this data. All information will be treated in the strictest confidence. Unsuccessful applicants will be retained for 3 months.

Signature^*

Date^*

Evantu Recruitment

Our Services

Register with us

At Evantu Recruitment we specialise in providing the best temporary and permanent staff to our clients in the health and social care sector.

Looking to Discuss Your Requirements?