Candidate Information

UK Candidate Application

Your Details
Title (eg Mr, Mrs, Dr):
First Name:
Last Name:
Sex:
Date of birth:
National Ins Number:
Grade:
Speciality:
Phone:
Work phone:
Mobile phone:
Email address:
Address 1:
Postcode:
Your application originated from?
Referral name:
Professional Membership Details
Association:
Membership Number:
Expiry Date:
HPC UK State Reg No:
Expiry Date:
Emergency Contact
Full Name:
Relationship:
Telephone:
Email:
Eligibility of Employment
Your nationality:
Immigration Status?
Equal Opporunities
We have an Equal opportunities Policy which is available upon request. For the sole purpose of monitoring our policy please complete the following:
White :
Asian :
Black :
Source
Please give details of where you found out about us.
If recommendation please provide name of referrer:
Journal/News:
Website:
Exhibition:
Job Board:
Promotion:
Other:
Working Requirements
Available date:
Available:
Preferred Clinical area:
1st Choice UK Geographical area:
2nd Choice UK Geographical area:
3rd Choice UK Geographical area:
Do you have a full UK driving licence:
Are you a car owner:
Working Hours
In line with Government legislation under the terms of 'Working Time Regulations' we recommend that your working hours should not exceed 48 hours per week (averaged over a 17 week period). Should you wish to waive this right, please confirm this by selecting below.
Do you wish to waive this right?
Additional Information
Please list periods of unemployment, gaps in employment, raising of family or educational breaks (details of which should also feature on your CV.
References
Reference 1
Organisation:
Department:
Name:
Job Title:
Address inc. Postcode:
Telephone:
Email:
May we contact immediately?
Reference 2
Organisation:
Department:
Name:
Job Title:
Address inc. Postcode:
Telephone:
Email:
May we contact immediately?

Declaration of Criminal Convictions

Have you ever been the subject of the following?

Disciplinary action:
Suspension:
Dismissal:
If yes, please describe:
Have you ever had a conviction, caution, reprimand or warning?
If yes, please give details and dates:
Do you have a criminal proceedings pending?
If yes, please give details and dates:
Do you have an original CRB/DBS certificate
If yes, please give date of issue:

Please upload a copy of your DBS/CRB, if you have one, at the bottom of this page.

Have you signed up to the DBS update service?
If yes, what is your Certificate or Application No:
Please confirm that you give consent to check DBS certificate on the update service?

File Uploads

Please make sure you upload the following:

Proof of ID (Passport, Birth Certificate Proof of Address, and proof of NI Number)
Proof of eligibility to work in the UK.
Qualifications certificates.
Passport style photo (can be a digital file).
Professional Registration Certificate (eg. HCPC)
Current CV.

Please note: Before being eligible for work we must view original versions of these documents. A consultant will contact you after registration to organise this step.

Please be aware if your attachments exceed 14mb (in total) this may result in the failure of your submission, if this should happen please go back one step and reduce the number attachments/file sizes accordingly.

Once you have successfully submitted your registration, you will receive an automatically generated email confirming this.

General Data Protection Regulation (GDPR) and Contact Consent.

All personal data provided by you (the applicant) will be treated as confidential and stored / managed on our secure servers. We do however require your consent to process and transmit your information to third parties for the purpose of finding you suitable employment and obtaining essential supporting documentation. This consent covers all information we may require whilst representing you; including but not limited to your application, training & compliance, work placements, payroll and general day-to-day correspondence.

Temporary work dictates the need for quick, effective communication for us to secure assignments for you. It is therefore essential for us to maintain regular contact with you across multiple channels. This includes; phone, Email, SMS and in-app push notifications (where applicable). Your consent is required for us to do so.

Do you give consent?

We take data privacy and security very seriously and your personal information will be processed and secured in accordance with The General Data Protection Regulations (GDPR). Our privacy policy can be viewed here

Once registered you can manage your correspondence / marketing preferences by logging into our Privacy Hub at; https://www.tpgplc.com/privacyhub/. Please be mindful that removing or limiting methods of contact could potentially reduce our response time, which in turn may result in you missing out on work opportunities.

Declaration

I declare that the details given by me on this application form are correct to the best of my knowledge and belief. I understand that if I have given any information which is false, or I withhold any relevant information, this may lead to my application being rejected, or if already appointed, to my dismissal.

I authorise JustNurses to disclose any convictions declared in this registration document to any potential employers in accordance with the DBS Code of Practice and the Rehabilitation of Offenders Act.

By selecting 'YES' below I also declare that I have read the JustNurses candidate handbook and accept the Terms & Conditions of Business.

Do you agree with the above statement?

JustNurses

Candidate Information

UK Candidate Application

Your Details

Professional Membership Details

Emergency Contact

Eligibility of Employment

Equal Opporunities

Source

Working Requirements

Working Hours

Additional Information

References

Reference 2

Have you ever been the subject of the following?

Please upload a copy of your DBS/CRB, if you have one, at the bottom of this page.

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