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Home » Applications


Applications

Job Applications

"*" indicates required fields

Step 1 of 2 - Job

50%
Name*
Town
Home
Mobile
Current Address*
DO YOU REQUIRE A WORK PERMIT TO WORK IN THE UNITED KINGDOM?*
DO YOU HAVE A WORK PERMIT?*
Max. file size: 125 MB.
Are you a registered member of NISCC?*
DO YOU HOLD A CURRENT DRIVING LICENCE?*
PLEASE TICK BOX IF YOU HAVE D1 CLASSIFICATION?
Are you willing and medically fit to drive company vehicles including minibuses?*
Education – GCSE, O’Level, A’Level, NVQ*
Subjects passed
Level Attained
Grade
Year
 
Further Education
Degree/Diploma/Certificate
Result & Date Obtained
Exams to be taken
 
Professional Qualifications (e.g. Nursing, Allied Health Professional, Social Care, Administration, Management)
Name of Professional Body
Part No. with Date & Result
Final with Date & Result
NMC Registration/Enrolment No./Pin No
Expiry Date
Exams to be taken
 

EMPLOYMENT HISTORY – PRESENT POST

EMPLOYMENT HISTORY – PAST

Please list all your previous posts beginning with the most recent including periods out of employment and any training
Name and Address of Employer
From dd/mm/yyyy
To dd/mm/yyyy
Reason for Leaving
Position/Grade and duties
 

CONVICTIONS/OFFENCES

Under the Rehabilitation of Offenders (Exceptions) Order Northern Ireland, 1979, Mainstay DRP is included on the list of excepted employers. As such, all criminal conviction may never be regarded as spent and must be disclosed when applying for a post. Therefore it is necessary we ask the following questions:

Have you ever been convicted of any criminal offence?*
Are you currently the subject of police investigation or do You have any prosecutions pending?*
Please note that disclosure of a conviction does not necessarily debar any applicant from obtaining employment
Have you been the subject of any investigation or enquiry into abuse or other inappropriate behaviour?*
Do you have or are subject to any disciplinary action? (This can be spent or pending)*

DISABILITY

The Disability Discrimination Act (DDA) defines a disabled person as someone who has a physical or mental impairment that has a substantial and long term effect on his or her ability to carry out normal day to day activities.* Substantial means neither minor or trivial • Long term means that the effect of the impairment has lasted or is likely last for at least 12 months • Normal day to day activity must affect one of the ‘capacities’ listed in the Act which include mobility, manual dexterity, speech, hearing, seeing and memory.

Do you consider yourself to have a disability, either physical or mental?*

PERSONAL DECLARATION

  1. I declare that all the foregoing statements are true, complete and accurate.
  2. I understand that if I give wrong information or leave out important information I could be dismissed if I take up this job.
  3. I understand that to take up this job I must have satisfactory references, health assessment and Access NI clearance.
  4. I understand that before taking this job I will have to submit to formal identification a copy of long birth certificate and evidence of qualifications.
  5. I confirm that as far as I know the information I have submitted on this form regarding my medical history and my ability to carry out this job are true, complete and accurate.
  6. I agree to the organisation making any necessary enquiries during the recruitment and selection process for this job.
  7. I understand that canvassing will disqualify me from the selection process for this job.
Consent*
How did you hear about this vacancy?

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