Employment Application Form
Please Fill Out the Form Below to Submit Your Interest in the role.
Name
*
First Name
Last Name
E-mail
*
example@example.com
Mobile Number
*
-
Phone Number
Address
*
Street Address
Street Address Line 2
City
County
Postal Code
Please select ALL branches you would be able and willing to commute to.
*
AT- Breaston
CS - Long Eaton
BG/NE - Newark
BL - Blackwell, Alfreton
CD - Castle Donington
CT - Cotmanhay
IY - Ilkeston
EL - East Leake
KH - Kirk Hallam
TD - West Hallam
RD - Ruddington
Do you hold a current driving licence
*
Yes, have own vehicle
Yes, no vehicle
No, having lessons
No
Do you have the right to work in the UK?
*
Yes, no restrictions
Yes, with restrictions (student visa, permit etc.) Give details below.
No
Please give details of work restrictions if applicable.
How clear is your spoken English for telephone calls?
*
1
2
3
4
5
Ok
Fluent and Professional
1 is Ok, 5 is Fluent and Professional
When are you available to work?
If applying for an advertised vacancy please check you can work the hours/day required.
Days available to work
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday Morning
Please give details of times that you CANNOT work or are NOT suitable for you. (Branch opening hours vary but are generally between 8:15am and 6:30pm)
Minimum number of contracted hours you would be happy to accept
*
per week
Maximum number of hours you are happy to work, including overtime.
*
per week
Are you physically able and comfortable to be on your feet for 8hrs per day?
*
Yes
Possibly not
Would need adjustments to be made
What adjustments would you require?
Do you have a valid UK certificate?
*
Medicine Counter Assistant
Dispensing Assistant
Technician/Checker
None
International pharmacy qualification
Do you have any practical pharmacy experience? What services can you offer? Please give details.
*
NMS, Checking, Additional services, further training
What do you understand about the role you are applying for? What do you think the main challenges would be, working in a pharmacy role
*
Please give details
Please give details of relevant previous experience and skills, including use of tills, computer systems, admin and customer facing, which would be transferrable to a pharmacy role.
*
From what date would you be available to start in the role ?
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Include notice period
I am happy for you to keep my details on file to be contacted for any upcoming vacancies for 12 months after this submission.
*
Yes, keep me on file
No, please remove my details.
Upload CV
Upload a File
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Any Other Documents to Upload
Upload a File
You can share certificates, diplomas etc.
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