Please ensure the form is completed as fully as possible as the information will be used to measure against the selection criteria.
Job title, Nexus Health Group site, and hours or work pattern.
Skills and qualifications
Please use this section to all skills, qualifications and experience you hold against the job descriptions and person specifications.
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Education and qualifications
Please list all qualifications you hold with dates and results
Experience
Please list all experience you have gained while working in relevant roles, with dates, if they were fixed term roles and job titles starting with your current or most recent role.
Present employment
Previous employment
Previous emloyment
Supporting statement
Please write a statement indicating why you feel that you are suitable for the post you have applied for. This should include examples of demonstrable experiences of how you meet the criteria for this role.
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Please provide the names and full contact details of the people who have agreed to supply references. References must as a minimum, cover a period of three years employment and/or training history, where this is possible.
Referees will be required to comment on your competence, personal qualities and suitability for the post. This may be your line/department manager, or someone in a position of responsibility for any work experience or placement undertaken. If you are a student or trainee this should include a teacher/tutor at your education institution.
If you have not been in employment for a considerable amount of time but have had previous employment, then you should seek one reference from your last known employer and a personal reference, you must provide contact details of two personal acquaintances who would be willing to give a reference. Personal acquaintances must not be related to you, or have any financial arrangement with you.
Please note that all reference requests will be followed up and verified by the recruiting employer.
Referees will be approached once an offer of employment has been made.
Referee 1:
Referee 2:
If you have applied for a position in the last six months, are you happy for us to use the references from your earlier application?
If you are related to / or have a relationship to anyone that works for Nexus Health Group, please state the relationship and with who.
The information in this form is true and complete. I agree that any deliberate omission, falsification or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal if employed by the organisation. Where applicable, I consent that the organisation can seek clarification regarding professional registration details.
NHS organisations recognise the benefits of having a diverse workforce and therefore welcome applications from all sections of the community. In addition to this, under the provisions of the Equality Act 2010, all NHS organisations are required to demonstrate that their recruitment processes are fair and that they are not discriminating against or disadvantaging anyone. Therefore a series of questions need to be raised in order to ascertain who is applying for each position and to ensure that no one is being unfairly discriminated against or disadvantaged.
This section of the application form will be detached from your application and will not be used as part of the selection process nor will it be seen by anybody who is interviewing you.
The information collected is only used for monitoring purposes in an anonymised format to assist the organisation in analysing the profile and make up of individuals who apply, are shortlisted for and appointed to each vacancy. In this way, they can check that they are complying with the Equality Act 2010.
Equality Act 2010
The Equality Act 2010 protects people against discrimination on the grounds of their age and sex
The Equality Act 2010 protects people who are married or in a civil partnership
The Equality Act 2010 protects bisexual, gay, heterosexual and lesbian people from discrimination on the grounds of their sexual orientation.
The Equality Act 2010 protects people against discrimination on the grounds of their religion or belief, including a lack of any belief.
The Equality Act 2010 protects people against discrimination on the grounds of their race which includes colour, nationality, ethnic or national origin.
Please indicate your ethnic origin:
The Equality Act 2010 protects disabled people. If you tell us that you have a disability we can make reasonable adjustments. If you require any reasonable adjustments please do let us know.
Please state the type of impairment which applies to you. People may experience more than one type of impairment, in which case you may indicate more than one. If none of the categories apply, please mark ‘other’.
