Application FormPlease enable JavaScript in your browser to complete this form.Name *FirstLastEmail *NMC PIN *Phone number *Address *Address Line 1CityState / Province / RegionPostal CodeUnited KingdomAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryNationality *National Insurance Number *Job category you are applying for *Personal Support WorkerRegistered Practical NurseRegistered NurseDo you hold valid driving license for the UK? *YesNoHow would you like to be paid? *PAYEDirect through UTR or company (Ltd)Are you eligible to work in the UK? *YesNoTraining and Education *Was your mandatory training - for example moving & handling, infection control, safeguarding, medication admin (RNs only) completed within the last year? Briefly outline any qualifications as well as professional & vocational training that you feel are relevant to this jobReferences *Please give details of two people that would be prepared to give you a reference. One must be from a current/previous employer; the other should be a character reference, from someone other than a family member. Any offer of employment will be subject to satisfactory references. By entering their details here, you give Macro Healthcare Ltd. permission to contact these people. Please include Name, Position, Organisation, Address, Email and Phone NumberLayoutHow many days/nights per week? *OneTwoThreeFourFlexibleWorking Preferences *Day ShiftsNight ShiftsWeekdaysWeekendsDBS status. Have you subscribed for the DBS Update Service? *Please selectYesNoIf you selected "Yes", please enter the number of the DBS certificate you subscribe with? Please note this is the DBS certificate number, not your subscription number.Previous Convictions * *Please give details of any convictions in this country or abroad you currently or have previously had. If none, please write the word “NONE” in this box. Please be aware that it is an offence to withhold this information.Health and Safety - Do you have a disability of any kind that may affect your work? please select. *YesNoIf you selected "Yes", please give details …Online data - We keep many of your records securely online. In addition, clients may ask that these are uploaded and shared online with their own client base (e.g. nursing & care homes), prior to the commencement of your first shift with them. Do you authorize that these details can be shared with them online? *YesNoWorking time regulations - the maximum working week is currently limited to 48 hours. As you are under no obligation to accept any work offered, you will not be compelled to work more than 48 hours per week. However, you may choose to do so. Please select. *I DO NOT wish to work more than 48 hours per weekI DO wish to work more than 48 hours per weekData Protection Our records, including any copies of documents supplied are kept securely in line with GDPR regulations. You understand & give permission for these to be made available from time to time to authorized personnel or inspectors, Home Office Immigration Check. If applicable, you understand & give permission for WCG Healthcare Ltd. to contact the appropriate authority in order to verify your current immigration status. Please tick. *YesUpload 1 (one) Category A supportive documents: • Current and valid UK Passport. • UK driving license photo card • UK Original Birth Certificate • A UK biometric residence permit card. * Click or drag a file to this area to upload. Upload 2 (two) Category B supportive documents: • A Bank or Building Society statement - less than 3 month old. • Utility Bill less than 3 month old. • A Credit Card statement • A Council Tax statement. • A mortgage statement. • A letter from: HMRC, Dept. of Works and Pensions, Jobcentre Plus or any other employment service. • A P45 or P60 statement, A pension or endowment or ISA statement. * Click or drag a file to this area to upload. Upload a Passport Style photograph. It must be clear, full face, no glasses or hats and against a white background. * Click or drag a file to this area to upload. What other language can you speak?Attach resume * Click or drag a file to this area to upload. Declaration - I confirm that I have read and understood the above and confirm my answers to be accurate and correct. Additionally, I understand that … It is my responsibility to update WCG Healthcare Ltd. in the event any of these details change in the future. Any job offer made to me is based on a zero-hours contract with no guarantee of work or working hours. Any job offer made to me is subject to satisfactory references being obtained from the individuals offered above. I give permission for WCG Healthcare Ltd. to contact the referees given. Upon acceptance, if I do not subscribe to the DBS Update Service, WCG Healthcare Ltd. will arrange a Disclosure and Barring Service (DBS) check now, and at intervals thereafter. I agree to pay the cost of this, determined at the time, either through deductions from my wages, or paid directly by me after three months from the DBS request being made, whichever is sooner. I also understand that WCG Healthcare Ltd. may contact the Home Office/UK immigration in order to verify my eligibility to work in the UK. If information given on this application form is found to be false it may result in disciplinary action, or dismissal. *YesApply