Careers – Integrated Healthcare Professionals Ltd

Job Application

Please complete all sections carefully.

Position Applying For

How did you hear about this vacancy?

Title (e.g. Mr, Mrs, Miss, Ms, Dr)

First Name

Middle Name

Last Name

Date of Birth

Full Address (including Postcode)

Phone/Mobile

National Insurance & Emergency Contact

National Insurance Number

Next of Kin / Emergency Contact Name

Relationship to You

Emergency Contact Full Address

Emergency Contact Phone Number

Right to Work in the UK

All applicants must be eligible to work in the United Kingdom.

Nationality

Are you eligible to work in the UK?

Yes

Do you require a Visa or Work Permit to work in the UK?

Yes

Visa Type

Visa Number

Visa Expiry Date

Passport Number

Passport Issue Date

Passport Expiry Date

Travel & Transport

Do you own a car?

Yes

How far are you willing to travel for work?

Would you use your vehicle to transport clients?

Yes

Professional Registration

Are you registered as a qualified nurse, doctor or social worker in any country other than the UK?

Yes

If yes, please state your profession and country of registration

Are you a registered Nurse or Social Worker in the UK?

Yes

Professional Body Name (e.g. NMC)

PIN Number

Registration Renewal Date

Professional Register Name

Work Availability

How many hours per week would you like to work?

Which days are you available to work?

Criminal Record & Professional Conduct

All information is treated in the strictest confidence.

Have you ever been convicted of any crime?

Yes

Please provide details of your conviction(s)

Have you ever been subject to professional misconduct proceedings or disciplinary action?

Yes

Please provide details of the misconduct proceedings

Have you ever been suspended or removed from the register of any professional body?

Yes

Please provide details of the suspension or removal

Have you ever been placed on a Sex Offenders register, POVA, POCA, ISA or DBS barred list?

Yes

Please provide details

Disability & Education

Do you have any disability?

Yes

Please describe your disability and any adjustments required

Level of Education

References

IHcPro requires a minimum of two references prior to confirming any offer of employment.

Reference 1 — Full Name

Reference 1 — Relationship / Position

Reference 1 — Full Address

Reference 1 — Phone Number

Reference 1 — Email Address

Reference 2 — Full Name

Reference 2 — Relationship / Position

Reference 2 — Full Address

Reference 2 — Phone Number

Reference 2 — Email Address

Supporting Documents

Accepted formats: PDF, DOC, DOCX, JPG, PNG. Max 10MB per file.

CV / Resume

Choose File

ID or Passport

Choose File

Visa / Work Permit (if applicable)

Choose File

Qualifications / Certificates

Choose File

Professional Registrations

Choose File

Proof of Address. (Attach upto 2 proofs)

Choose File

Applicant's Declaration

I confirm that I have read and understood this application form. I understand that completion of this form does not guarantee employment. I certify that all the information given is true and complete, and I accept that any mis-statement or suppression of material facts may result in the cancellation of any appointment and/or the termination of any employment with Integrated Healthcare Professionals Ltd.

Join Us

Current Vacancies

Job Application

National Insurance & Emergency Contact

Right to Work in the UK

Travel & Transport

Professional Registration

Work Availability

Criminal Record & Professional Conduct

Disability & Education

References

Supporting Documents

Applicant's Declaration