Tanern Staffing Solutions

Tanern Staffing Solutions

Healthcare application form
Photo ID
Name*

First NameLast Name
Date of birth*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
DATA PROTECTION STATEMENT
The personal information (DATA) collected on this form and on the attachments, (which includes the collection of sensitive personal data) are collected for the purposes of recruitment, personnel administration (For new employees) and monitoring. Unless you direct Tanern Staffing Solutions, otherwise (for example where you would like this application kept on file for future vacancies) the application forms (and attachments) of unsuccessful applicants will be destroyed after 6 months. It is the Policy of Tanern Staffing Solutions to protect, and keep secure, all personal data collected. All personal data is processed for the purposes of recruitment and in the case of successful applicants, for the satisfactory administration of their employment and for no other purpose.
EQUAL OPPORTUNITIES STATEMENT
The organisation’s equal opportunities policy covers all employees, or potential employees and embraces the principle that all people shall be treated equally, regardless of their age, gender, ethnic origin, nationality, colour, religion, marital status, sexual orientation, religion or belief, disability, or offending background.
Position applied for *
Approx. no. of hours wanted: *
Select one*

Full timePart time
When are you able to work?*

MorningsAfternoonsEveningsDaysNightsWeekends only
Education and Training*
Qualifications*
Previous Employers*
Supporting Statement*
Interview arrangements and availability *
Are there any dates when you will not be available for the interview?*
When can you start working with us?*
Do you need a work permit to work in the UK?*

YesNo
EMPLOYMENT HISTORY
Name and address of your most recent/last employer*
Date Employed*
Nature of business:*
Position held and reason for leaving:*
Salary/ Rate:
ASSISTANCE WITHINTERVIEW AND ASSESSMENT
Do you require us to make any special arrangements for you to participate in this recruitment process? For example, large print forms? Or additional time to complete the forms*

YesNo
If yes, please give details
Any offer of employment may be made subject to a satisfactory medical report.
GP’s name
Tel no
Address:
(Your GP will never be contacted without your permission)
Next of kin:

Please provide details of a Next of Kin living in the UK ONLY.
Name

First NameLast Name
Telephone Number
Please enter a valid phone number.
Relationship
Address
IDENTITY DETAILS
Nursing and Midwifery Council PinNumber: (Nurses Only)
National Insurance Number: (All Applicants)
CAPACITYTO WORK IN THE UK
Are there any restrictions to your residence which might affect your right to take up employment in the UK?

YesNo
If yes, please provide details.
References

Please give the names and contact details of 2 people who we can ask to give you a reference. We may ask them before an employment offer is made. We will not ask your current employer until we get your permission.
Referee 1*
Referee 2
Declaration

I confirm that to the best of myknowledge the information I have provided on this form is correct and I acceptthat providing deliberately false information could result in my dismissal.
Name*

First NameLast Name
Signature*

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Date*

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Tanern Staffing Solutions

Healthcare application form
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Tanern Staffing Solutions

DATA PROTECTION STATEMENT

EQUAL OPPORTUNITIES STATEMENT

EMPLOYMENT HISTORY

ASSISTANCE WITHINTERVIEW AND ASSESSMENT

Any offer of employment may be made subject to a satisfactory medical report.

(Your GP will never be contacted without your permission)

Next of kin:

IDENTITY DETAILS

CAPACITYTO WORK IN THE UK

References

Declaration

Tanern Staffing Solutions