Employment Application Form

Employment Application

Please complete the form below accurately indicating your potentials and suitability to job applying for.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityCounty

Post Code
Birth Date*

DayMonthYear
Email*
example@example.com
Contact Phone Number*

+44Phone Number
Do you have the right to work in the UK? *
NI Number
If you do not hold a British Passport - Please provide share code or resident permit.

Have you held a current full UK (manual) driving licence for at least 3 years? *
Do you have any endorsements/ points on your licence?*

YesNo
Have you any motoring convictions?*

YesNo
If you have answered YES to either of the last two questions, please provide detail including rates and reasons.

Clinical Grade *
If applicable, please enter professional body registration.
HCPC/NMC
Please upload Medical Qualification Certificate:*

i.e. FREC4, Paramedic degree
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Please upload Passport *

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Please upload Driving Licence - Front and Back

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Please upload Proof of address *

i.e. bank statement or utility bill dated within 3 months
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Please upload Blue Light Driving Certificate:

i.e. IHCD or CERAD
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Please upload current CV *

Must include employment history of 10 years
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Gaps in Employment History
Please provide reason and date for any gaps in employment history.
Please upload DBS certificate

Must be on the update service
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Are you subscribed to the update service with the DBS certificate uploaded?

YesNo
Please upload mandatory training certificates:

Infection Control, Information Governance, Fire Safety, Manual Handling E-Learning, Equality & Diversity, Health & Safety, Conflict resolution, Prevent, Safeguarding Adults - Level 3, Safeguarding Children - Level 3, Safeguarding Delivery F2F, Dementia Awareness.
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How did you hear about LMS? *

ReferralFacebookLinkedInOther
Declaration

I declare that the information given in this form, and any supplementary documentation, is complete and accurate. I understand that any false information or deliberate ommision will disqualify me from this application process or may render me liable for summary dismissal. I understand these details will be held in confidence by the Company in compliance with Data Protection Act 2018 and GDPR. I also understand that the application form may be shared with our customers, in confidence, if required.
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