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NHS Scotland Application Form
Candidate identification number (office use only): Please ensure you complete the application form in full as we cannot accept CVs. Please complete with black ink and block capitals. This form will be kept in confidence when completed and returned to us. PART A Application for (Job Title): Job Reference No:
Location:
Candidate ID No:
No applicant will be unfairly discriminated against. We are particularly alert to eliminating discrimination on account of age, cultural/religious/political belief, disability, ethnicity, gender, race, relationship status, sexual orientation, and/or Trade Union membership or stewardship. Only 'Part C' of this form will be made available to short-listing panels. Parts A, B and C would then be used by the interviewing panel if you are selected for interview. Personal Details Surname: Name known: Address: Forename: Title:
Post Code: Contact Telephone Numbers: Evening: E–mail: If we need to, the best way for us to contact you is by: Work Permit Do you need a work permit to take up this post? Working in the UK Are you eligible to work in the UK? Day: Mobile:
Yes Yes
No No
Page 1
NHS Scotland Application Form
Job Reference No: Candidate ID No: Declarations
PART B
Convictions NHS Scotland is exempt from the 1974 Rehabilitation of Offenders Act (Exclusions & Exceptions) (Scotland) Order 2003. This means that unless stated in the job description, person specification or application pack, you must tell us about any previous convictions either classed as ‘spent’ or ‘unspent’. If you are offered employment, any failure to disclose such convictions could result in dismissal or disciplinary action. Any information you give will be considered only in relation to the post for which this application form refers. Information will be verified by Disclosure Scotland for relevant posts. I declare that I have: (a) No previous convictions (b) Previous convictions – details of which are:
Candidate identification number (office use only): Please ensure you complete the application form in full as we cannot accept CVs. Please complete with black ink and block capitals. This form will be kept in confidence when completed and returned to us. PART A Application for (Job Title): Job Reference No:
Location:
Candidate ID No:
No applicant will be unfairly discriminated against. We are particularly alert to eliminating discrimination on account of age, cultural/religious/political belief, disability, ethnicity, gender, race, relationship status, sexual orientation, and/or Trade Union membership or stewardship. Only 'Part C' of this form will be made available to short-listing panels. Parts A, B and C would then be used by the interviewing panel if you are selected for interview. Personal Details Surname: Name known: Address: Forename: Title:
Post Code: Contact Telephone Numbers: Evening: E–mail: If we need to, the best way for us to contact you is by: Work Permit Do you need a work permit to take up this post? Working in the UK Are you eligible to work in the UK? Day: Mobile:
Yes Yes
No No
Page 1
NHS Scotland Application Form
Job Reference No: Candidate ID No: Declarations
PART B
Convictions NHS Scotland is exempt from the 1974 Rehabilitation of Offenders Act (Exclusions & Exceptions) (Scotland) Order 2003. This means that unless stated in the job description, person specification or application pack, you must tell us about any previous convictions either classed as ‘spent’ or ‘unspent’. If you are offered employment, any failure to disclose such convictions could result in dismissal or disciplinary action. Any information you give will be considered only in relation to the post for which this application form refers. Information will be verified by Disclosure Scotland for relevant posts. I declare that I have: (a) No previous convictions (b) Previous convictions – details of which are: