Event Bank Staff Application
Name
First Name
Last Name
Are you registered as a Doctor, Nurse or Paramedic or other HCP?
Please Select
No
Doctor
Nurse
Paramedic
Nurse and Paramedic
Other
What is your professional registration number? i.e. HCPC, NMC, GMC
Do you have any current restrictions on your practice or under any current investigation (HCPC/NMC/GMC/Employer/Police)? If yes, please outline below:
Personal Email
example@example.com
Mobile Number
Home Address
Name of your Emergency Contact
Relationship of Emergency Contact
Emergency contact number
Do you have any access requirements you would like us to be aware of?
Employment Document
Please upload the following documents in order for us to process your application effectively:
Driving License Picture (front & back)
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Driving License Check Code (https://www.gov.uk/view-driving-licence)
Please upload a copy of your latest DBS Certificate (Within 3 years)
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Or please provide us with your DBS update service Reference number
Please upload a copy of your clinical certificates (include training or qualification certificates, university transcripts etc)
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Please upload a copy of your Bluelight/Emergencydriving Qualification
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Passport Style Photo
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Please upload a passport style photo. This is for the purpose of identification and to create an identification card if you are successful in your application.
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References
Please provide the details of two separate people we can contact to provide employment references:
Name (Reference 1)
First Name
Last Name
Relationship to you
Email
example@example.com
Name (Reference 2)
First Name
Last Name
Relationship to you
Email
example@example.com
Submit
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