Training Hub Employment Application Form

Please complete the form below and click the submit button once you have finished. (If your form does not submit, please scroll to check it for any missing red fields.)

If you have any queries, please email candptraininghub@nhs.net or call us on 01733 666670.

Training Hub Employment Application Form

Date of Application*
DD slash MM slash YYYY
Which position are you applying for:*
Full Name*
Address:*
Please enter your full address including postcode.
Telephone Number*
Email Address*
Are you currently eligible for employment in the UK?*
If you are short-listed for this post you will be asked to provide identification documentation in accordance with the Immigration, Asylum and Nationality Act 2006
Do you have a disability as defined by the Equality Act?*
DISABILITY The Equality Act 2010 defines disability as a physical or mental impairment which has a substantial and long term adverse effect on a person's ability to carry out normal day to day activities
Do you have requirements that would aid you at interview or at work?*
If yes please give details below:
Details of requirement(s):
Do you have any convictions or cautions?*
If yes, you will be asked to specify in a separate communication. DISCLOSURE OF CRIMINAL CONVICTIONS AND POLICE CAUTIONS, WARNINGS AND REPRIMANDS INCLUDING SPENT ITEMS This post is exempt from the provisions of section 4(b) of the rehabilitation of offenders act by virtue of the rehabilitation 1974 (exemptions) order 1975 because of the nature of work involved. You are therefore not entitled to withhold information and in the event of employment, any failure to disclose such convictions could result in dismissal or disciplinary action. We will be required to obtain a Disclosure and Barring Service Check for individuals appointed to certain posts.
NMC Pin:*
CURRENT / LAST EMPLOYER Name and Address:*
EMPLOYMENT HISTORY Please list most recent employer and work backwards providing a minimum of 5 years employment history
Start date & Leaving date:*

Month & year employed from and month & year employed to
Current / Last Employer - Position Held:*
Current / Last Employer - Responsibilities*
Current / Last Employer - Reason for leaving?*
Notice Period

(If applicable)
PREVIOUS EMPLOYER Name and Address:
Previous Employer - Start date & Leaving date:

Month & year employed from and month & year employed to
Previous Employer - Position Held:
Previous Employer - Responsibilities
Previous Employer - Reason for leaving?
Previous Employer's Name and Address:
Previous Employer - Start date & Leaving date:

Month & year employed from and month & year employed to
Previous Employer - Position Held:
Previous Employer - Responsibilities
Previous Employer - Reason for leaving?
Previous Employer's Name and Address:
Previous Employer - Start date & Leaving date?

Month & year employed from and month & year employed to
Previous Employer - Position Held?
Previous Employer - Responsibilities
Previous Employer - Reason for leaving?
EDUCATION AND QUALIFICATIONS*
Please list most recent first, and include: Name of Establishment, Subject, From/to dates, Qualification(s) achieved including Grade/Classification
OTHER TRAINING/SHORT COURSES:
Please list most recent first and include: Course Name, Subject, Date, accreditation achieved
EMPLOYMENT REFERENCE 1 - Current or most recent employer*
PLEASE INCLUDE THE FOLLOWING REFEREE INFORMATION: Name, Relationship (e.g. line manager), Position, Company, Address, Telephone No, Email address.
EMPLOYMENT OR ACADEMIC REFERENCE 2*
PLEASE INCLUDE THE FOLLOWING REFEREE INFORMATION: Name, Relationship (e.g. line manager), Position, Company, Address, Telephone No, Email address.
Do you hold a current driving licence?*
Do you have use of a car?*
STATEMENT IN SUPPORT OF YOUR APPLICATION*
Please use this space to tell us how your skills and experience match the essential and desirable skills listed in the person specification.
Email
This field is for validation purposes and should be left unchanged.

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