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Nightingale's Care Application Form

Registered Nurse / Care Assistant Application Form

Application for the post of: REGISTERED NURSE / CARE ASSISTANT

PLEASE NOTE: Due to the nature of our business, we can only consider applicants with a full driving licence and their own transport.

Registered Nurses are required to have a minimum of six months' clinical experience within the past two years which can be supported by a suitable referee. Care Assistants are required to have a minimum of six months' care work experience.

Section 1: Personal Details

Section 2: Current Employment

Section 3: Previous Employment

Please give details of previous employment together with relevant dates, starting with the most recent.

This post is exempt from Section 4(2) of the Rehabilitation of Offenders Act 1974 (Exemptions) (Amendment) Order 1986. It is not, therefore, in any way contrary to the Act to reveal any conviction(s) which would otherwise be considered as 'spent'.

Section 4: Qualifications

Section 5: Computer Literacy

As more and more homes and hospitals are turning to computerised patient/resident records, please indicate your level of computer experience:

Section 6: Work Availability

Please indicate below the approximate number of hours available per week and times preferred.

Days *

Nights *

Weekdays *

Weekends *

Bank holidays *

Section 7: Work Preferences

Please indicate in which of the following areas you would prefer to work:

Domiciliary (home care) *

Hospitals *

Residential & care homes *

Learning difficulties *

Section 8: References

Please nominate two referees. If in employment, one referee should be your present or immediate past employer. A character reference should be someone who has known you for 3 - 5 years. No family members are allowed to give you a character reference.

Section 9: Any Additional Information