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Home
About Us
Our Services
Complex Care
Convalescent care
Domiciliary Care
Respite Care
Palliative care
Recruitment
Apply Now
Contact Us
Apply Now
Our Passion Is Your Health
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Your Personal Details
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Title (Mr, Mrs etc.)
Mr
Mrs
Miss
Ms
Sex
*
Male
Female
Contact Name
*
First
Last
Address
*
Address Line 1
City
State / Province / Region
Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
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Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ã…land Islands
Country
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Mobile Telephone:
*
Age
*
National Insurance No:
*
Contact Email
*
Home Telephone:
Date Of Birth:
*
Next
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What is the earliest date you could start work with us?
Do you hold a current UK driving licence?
Yes
No
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Previous
Next
We require your work history including periods you may have spent out of employment. Therefore, please list your full employment history here, including any periods when you were not working with a brief explanation of what you were doing. You may use the "additional info" box below.
Please start with your current or most recent employment and work backwards. We require 5 years of work history.
Employment 1
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Place of employment
Position:
Period of Employment: From: To:
Brief Description of Duties:
Reason for leaving:
Employment 2
Layout (copy)
Place of employment:
Position:
Period of Employment: From: To:
Brief Description of Duties:
Reason for leaving:
Employment 3
Layout (copy)
Place of employment:
Position:
Period of Employment: From: To:
Brief Description of Duties:
Reason for leaving:
Employment 4
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Place of employment:
Position:
Period of Employment: From: To:
Brief Description of Duties:
Reason for leaving:
Employment 5
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Place of employment:
Position:
Period of Employment: From: To:
Brief Description of Duties:
Reason for leaving:
Additional info:
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Next
We take our responsibility to protect our clients very seriously at NuHealth Care Services LTD. Your appointment depends on the successful completion of a criminal records disclosure. At this point, we require you to answer the following questions truthfully and honestly:
Have you received any convictions, cautions, reprimands or final warnings that are not ‘protected’ as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013 by SI 210 1198)?
*
Yes
No
To your knowledge, are you currently the subject of any criminal proceedings (for example, charged or summoned but not yet dealt with) or under any police investigation?
*
Yes
No
If you answered ‘yes’ to either of the two previous questions, please provide details:
Do you consent to NuHealth Care Services LTD applying for an enhanced criminal records disclosure on you and keeping a copy of your disclosure certificate for the duration of your employment or until a new disclosure is completed
*
Yes
It should be noted that if it is discovered after a criminal records disclosure that you have failed to accurately disclose the information requested above, the company reserves the right to terminate your employment without notice. Please be aware, however, that having a criminal record does not automatically preclude us from hiring you; if you would like to learn more about our policy on the recruitment of ex-offenders, please enquire.
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We accept references for a minimum of three years. One reference should be from your current employer. College or University graduates should identify their lecturers/tutors/professors. Please keep in mind that friends and family do not qualify as suitable referees.
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Current Employer
Title and Name of Reference
Address and postcode of referee:
*
Address Line 1
City
State / Province / Region
Contact Number
*
Email address:
*
Capacity Known to you:
*
Do you give us permission to contact your referee?
*
Yes
No
2 nd Reference
Title and Name of Reference
Address and postcode of referee:
*
Address Line 1
City
State / Province / Region
Contact Number
*
Email address:
*
Capacity Known to you:
*
Do you give us permission to contact your referee?
*
Yes
No
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Curriculum Vitae
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DBS
Click or drag files to this area to upload.
You can upload up to 2 files.
Education Certificates
*
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You can upload up to 5 files.
Immunisation Certificates
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PIN or NMC Statement of Entry
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Indemnity Insurance i.e. RCN/UNISON membership
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Identification Documents (Passport or UK Driving License)
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Passport Size Photograph
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Mandatory Training Certificates
Click or drag files to this area to upload.
You can upload up to 5 files.
Proof of Address 1
Click or drag a file to this area to upload.
Proof of Address 2
Click or drag a file to this area to upload.
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