Application for Employment


Section 1       Personal Details

Click or drag a file to this area to upload.

Job Share Details

Driving License – if relevant to post applied for.

If you are successful you will be required to provide relevant evidence of the above details prior to your appointment.

Section 2       Present Employment

Section 3       Previous Employment

Previous Employment (most recent employer first). Please cover the last 10 years and state nature of business - if not public sector

Section 4       Education

Qualifications obtained from Schools, Colleges and Universities. Please list highest qualification first:

Professional, Technical or Management Qualifications

Please give details:

Section 5       Training and Development

Please give details of any training and development courses or non-qualifications courses which support your Application. Include any on the job training as well as formal courses.

Section 6       Personal Statement

Abilities, skills, knowledge and experience.

Please use this section to explain in detail how you meet the requirements of the Employee profile.If you or have been involved in voluntary/unpaid activities ,please also include these information.Attach and label any additional sheets used.

Section 7       Rehabilitation of Offenders Act (1974)

The post you are applying for, unless otherwise stated, is exempt from Section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. You are therefore, required to disclose here any convictions (including ‘spent’ convictions) for criminal offences brought against you and any pending court action.

Section 8       Protecting Children and Vulnerable Adults (1974)

The following information may be required if the post you are applying for has a requirement for a Criminal Records Bureau police check.

Enhanced Checks

Section 9       Disability Discrimination Act

This Act protects people with disabilities from unlawful discrimination. We actively encourage applications from people with disabilities. The Disability Discrimination Act defines a disabled person as someone who has a physical or mental impairment which has a substantial and adverse long term effect on his or her ability to carry out normal day to day activities.

We will try to provide access, equipment or other practical support to ensure that people with disabilities can compete on equal terms with non-disabled people.

Section 10       Health

Successful applicants will be required to complete a detailed medical questionnaire and may be required to attend a medical examination prior to being appointed.

Section 11       References

Please give the names and addresses of four referees (two of which MUST be your most recent employers). If you are unable to do this, please clearly outline who your referees are. Reference 3 & 4 will only be used should we be unable to contact references 1 or 2.

Reference 1
Reference 2
Reference 3
Reference 4

Section 12       Recruitment Monitoring Form

This sheet will be separated from your application form upon receipt and does not form part of the selection process. It will be retained by the Human Resources purely for monitoring purposes.

Instant Healthcare UK wants to ensure that all applicants are treated equally whatever their race, colour or ethnic origin. To do this we need to know about the ethnic origin of people who apply to join us. These categories were used in the 2011 Census and are listed alphabetically. Which groups do you most identify with?

Please mark ‘X’ in only ONE box in column A and only ONE box in column B

Section 12       Recruitment Monitoring Form continued

Sexual Orientation

Instant Healthcare UK wants to ensure that all applicants are treated equally whatever their sexual orientation. To do this we need to know about the sexual orientation of people who apply to join us. We would therefore be grateful if you would complete the following question. Your answer will be treated in the strictest confidence and will not affect your job application in any way.
Which group do you most identify with? The options are listed alphabetical order.

Please mark ‘X’ in one box only:

Religion or Belief
What is your religion or belief (including non-belief)? Please mark ‘X’ in the box below as appropriate.

Disability is defined as “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”.


Section 13       Declaration

A. Relatives/Other Interests

Any candidate who directly or indirectly canvasses a member of Instant Healthcare UK Staff will be disqualified from consideration for the job. The Company does not bind itself to appoint any applicant.

B. Statement to be Signed by the Applicant

Instant Healthcare UK is committed to an anti-fraud culture and participates in statutory anti-fraud initiatives.

Please complete the following declaration and sign it in the appropriate place below. If this declaration is not completed and signed, your application will not be considered.

I agree than Instant Healthcare UK may use information provided on this form for prevention and detection of crime and it may share this information with other bodies solely for these purposes. I hereby give consent to such collection, storage and processing of my personal data and I agree that the information given on this form may be used for data registration purposes. I hereby certify that:
  • all the information given by me on this form is correct to the best of my knowledge
  • all questions relating to me have been accurately and fully answered
  • I possess all the qualifications which I claim to hold
  • I have read and, if appointed, am prepared to accept the conditions set out in the conditions of employment and the job description.
  • (NB. Candidates selected for interview will normally be notified within three weeks of the closing date. Unfortunately applicants who do not hear from Instant Healthcare UK must conclude that their application has been unsuccessful on this occasion. Thank you for your interest in this post. If you would like to know if we have received your application form please enclose a stamped addressed post card.

    Instant Healthcare UK undertakes that it will treat any personal information (that is data from which you can be identified, such as your name, address, e-mail address etc) that you provide to us, or that we obtain from you, in accordance with the requirements of the Data Protection Act 1998.