Mitchell & Murdoch Application Form
Please ensure that you complete the application form in full as we cannot accept CVs. This form will be kept in confidence. Please note that no applicant will be unfairly discriminated against. This includes discrimination on account of age, cultural/religious/political beliefs, disability, ethnicity, gender, race, relationship status, sexual orientation, and/or Trade Union membership or stewardship. If you have any special requirements to support you to complete this form (e.g. the need for large print or additional time) please contact the Registered Manager on 01738 505970.
Street Address Line 2
State / Province
Postal / Zip Code
Do you currently have your own transport
If you hold a drivers license, how many years have you held this?
NMC/ SSSC registration Number (If applicable)
NMC/ SSSC registration expiry date (if applicable)
Are you a United Kingdom (UK), European Community (EC) or European Economic Area (EEA) National ?
If no, please detail current immigration status and the relevant visa currently held (including Visa number):
If you are an EU National, please provide your EU Share Code.
For more information on EU Share Codes please visit
National Insurance Number
Are you are related to a member of staff or Service User at Mitchell and Murdoch Care Ltd
Position Applied For:
Amount of work looking for and days preferred/wanted?
Equality Act 2010
Under the Equality Act 2010 the definition of disability is if you have a physical or mental impairment that has a “substantial” and “long term adverse effect” on your ability to carry out normal day-to-day activities. Further information regarding the definition of disability can be found at: www.gov.uk/definition-of-disability-under-equality-act-2010.
For the purposes of this application and the interview stage only, is there anything you would like us to be aware of so that we can make reasonable adjustments during the process?
Prefer not to discuss
If yes, please provide details
Provide details of your education
Training Courses Attended or Completing
Provide details of your Education
Provide details of your employment history here
Please detail any gaps in employment
Please add here your reasons for applying. You should refer to the job description and person specification to guide you. It would also be of value to describe particular strengths and talents that set you apart from others including skills gained from work, home and other activities.
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