Join the Newman Healthcare Team

Please complete all sections that apply to you. Fields marked * are required. It takes about 15 minutes.

Position applied for

Which position are you applying for? *

If others, please specify

For nurses only, what is your NMC PIN number?

About you

Title

First name *

Middle name

Surname *

Surname at birth, if different

Original nationality

Nationality today

Date of birth

Place of birth

Contact details

Current address

Post code

Mobile telephone number *

Other number, if applicable

Email address *

National insurance number

Do you hold a full and valid UK driving licence?

Do you normally have access to a car to get to/from work?

How did you hear about Newman Healthcare Ltd?

Payment details

Staff paid through PAYE and earning over the qualifying amount per fortnight are automatically enrolled into the workplace pension.

How would you like to be paid?

If applicable, your UTR or company name

Eligibility to work in the UK

Where a question does not apply, enter N/A.

Do you require a work permit to work in the UK?

If yes, which type of permit do you have?

Hours permitted per week

Permit copy provided?

Do you currently require immigration permission to work in the UK?

Current UK immigration / right-to-work status

Is your right to work time-limited? If yes, when does it expire?

Are you sponsored under a Skilled Worker or Health and Care Worker visa?

Sponsored occupation/job title and SOC code, if known

Contracted hours per week with your sponsor

Restrictions on additional employment? If yes, give details

Home Office right-to-work share code

Employment history

Your employment history within the past 5 years, most recent first. Include employment gaps.

✓1. Company

Role

Email address

Contact details

Date from

Date to

Reason for leaving

✓2. Company

Role

Email address

Contact details

Date from

Date to

Reason for leaving

✓3. Company

Role

Email address

Contact details

Date from

Date to

Reason for leaving

Previous convictions

Do you have any convictions in this country or abroad? *

If yes, give details. If none, write NONE.

References

Two professional references and one character reference from someone other than a family member.

✓Reference 1 (professional) – name *

Position

Organisation

Email address

Telephone

Address

✓Reference 2 (professional) – name *

Position

Organisation

Email address

Telephone

Address

✓Reference 3 (character) – name

Position

Organisation

Email address

Telephone

Address

Emergency contact

Name

Telephone

Address

Post code

DBS status

We must determine your current DBS status through the DBS Update Service or by requesting a new certificate.

Have you subscribed to the DBS Update Service?

DBS certificate number

Working preferences

When would you prefer to work?

Day ShiftsNight ShiftsWeekdaysWeekends

Details of any other employment you currently have

Have you worked night shifts before?

Have you ever suffered health problems working night shifts?

If yes, give details

Can you sleep in the day after night shifts without health problems?

Working time regulations

Health and safety

Do you have a disability of any kind that may affect your work?

If yes, give details

Special needs or medical conditions others may need to know in an emergency?

If yes, give details

Allergies or religious beliefs that prevent working with specific foods?

If yes, give details

Do you authorise your records to be shared securely online with client organisations when required?

Declaration

Records and document copies are kept securely in line with GDPR. If applicable, you give permission for Newman Healthcare Ltd to verify immigration status with the appropriate authority.

Please confirm each statement *

I confirm my answers are accurate and correct.I will update Newman Healthcare Ltd if these details change.I understand any job offer is a zero-hours contract with no guarantee of work or hours.I give permission for Newman Healthcare Ltd to contact the referees provided.I agree to DBS checks now and at intervals thereafter where required.I understand Newman Healthcare Ltd may contact the Home Office/UK immigration to verify eligibility to work.I understand false information may result in disciplinary action or dismissal.

Signed (type your full name) *

Date *

Upload your CV

Upload your CV in any format (PDF, photos or Word).

Click to choose filesor take a photo on your phone

Job application form

Position applied for

About you

Contact details

Payment details

Eligibility to work in the UK

Employment history

Previous convictions

References

Emergency contact

DBS status

Working preferences

Health and safety

Declaration

Upload your CV