Application form

    Applicant Details




    Next Of Kin

    Nationality

    Evidence of all passports and visas are required. Please enclose photocopies with this application form and make sure you bring the originals to your interview. To work in the NHS you will be expected to communicate proficiently in English and this will be assessed at your interview.

    I confirm that during every assignment and afterwards, I will:

    • Hold information relating to the client in the strictest confidence, ensure it is kept safely and securely when not in use. I acknowledge that no information is to be removed from the client’s premises without the permission of the Client;

    • Use such information only for the purpose of the work for which it was given;

    • Not disclose to any third party or copy the information except as is required in the course of my duties.

    • In the event of a breach; either by me or a third party that may result in legal proceedings being bought by the Client against me, recover any losses that have occurred as a result of a breach.

    Data Protection Act 1998 / The General Data Protection Regulations 2018

    In relation to the Data Protection Act 1998 / The General Data Protection Regulations 2018, you agree to the processing of personal data for the purposes of the recruitment process as well as for future potential employment arrangements for the purposes of calculating your remuneration and maintaining records on attendance, health, discipline and grievances such as are necessary for the performance of your contract. Our full GDPR Privacy Notice can be found on our website.
    For further information, please see the Information Commissioner's website ww.dataprotection.gov.uk, from which the above guidance is reproduced.

    Declarations

    In line with the Government legislation under the terms of the “Working Time Regulations” we recommend that your working hours should not exceed 48 hours per week (averaged over a 17 week period.)

    I understand that information give on this form will be stored and handled by Apex Recruit in accordance with the Data Protection Act 1988, however, I agree that this information may be made available for audit by the relevant Government organisations e.g. CCS / CPP Framework.

    Data Protection Act 1998 / The General Data Protection Regulations 2018

    In relation to the Data Protection Act 1998 / The General Data Protection Regulations 2018, you agree to the processing of personal data for the purposes of the recruitment process as well as for future potential employment arrangements for the purposes of calculating your remuneration and maintaining records on attendance, health, discipline and grievances such as are necessary for the performance of your contract.

    Our full GDPR Privacy Notice can be found on our website. For further information, please see the Information Commissioner's website ww.dataprotection.gov.uk, from which the above guidance is reproduced.

    I acknowledge that I have been given a copy of the terms and conditions of service issued by Apex Recruit, which is mine to keep and further more that I have read those terms and conditions and agree to abide by them. I am not aware of any condition, medical or otherwise which would affect or limit my employment or performance, other than those declared in my Pre-employment Health Questionnaire From and I am fit for work.

    I authorise Apex Recruit to disclose any convictions to any potential employers in accordance with the DBS Code of Practice and the Rehabilitation of Offenders.
    I declare that the details given by me on this application form are correct to the best of my knowledge and belief.

    I understand that if I have given any information which is false, or I withhold any relevant information, this may lead to my application being rejected, or if already appointed, to my dismissal, as well as a claim for recovery of any payments I have received, together with a claim for loss of profit to Apex Recruit.

    I also give Apex Recruit Permission to apply and to check my DBS certificate on the UK DBS update service annually.

    I give Apex Recruit Permission if required to conduct any relevant right to work checks Via the Government websites.

    Influenza Vaccine History

    Employment Reference

    You are required to supply at least two employment references. The 2 referees provided must cover at least 3 years employment (current/most recent). Please provide details for the manager/supervisor for each reference.

    First Reference

    Company Address

    Second Reference

    Company Address

    Equal Opportunities

    As an Equal Opportunities employer the organisation welcomes applications from suitably qualified persons from all sections of the community. The organisation is committed to achieving a working environment which provides equality of opportunity and freedom from discrimination on the grounds of race, nationality, religion, gender, class, family responsibilities, marital status, sexual orientation, age, disability or special need.
    The Directors believe in best practice in Equal Opportunities on the grounds of morality, good business practice and awareness that certain kinds of discrimination are unlawful. This is a key employment value to which all employees and candidates are expected to give their support. To ensure that the policy is effective it is essential that detailed monitoring is carried out, which necessitates the collection of information.
    The information on this form will be kept confidential and will not be used by those involved in the selection procedure and is for statistical purposes only and will not form part of any job application.

    Criminal Record Declaration

    If you haven’t completed a DBS (previously DBS) check through Apex Recruit, or if the last one was completed over 12 months ago, you are required to complete the attached DBS form provided so that we may undertake an Enhanced DBS check on your behalf. You will not be place in employment without having completed a current DBS check.
    Please ensure you enclose all original documentation (e.g. passport) as photocopies will not be accepted and your form will be returned to you.


    I declare that all the foregoing statements are true and complete to the best of my knowledge.

    Should the situation change whilst either:

    1. I am engaged on a temporary Assignment by Apex Recruit;

    2. In between Assignments for Apex Recruit;

    I will immediately notify Apex Recruit.

    I understand that if any of the information provided on this application is later found to be incorrect, my employment may be terminated.

    Contact us

    If you have any issues with your application or just want to ask us a question, then please feel free to contact us on:
    07396740376 / 07375062527 or hello@apex-recruit.co.uk