HCA/Support Worker Application Form

This information will only be used in emergency, e.g. if you don't turn up to a shift and we're unable to reach you after multiple attempts.

Please add your employment history by either uploading a current CV or completing your employment history in the tabs below . Explain any gaps of more than three months.

Please provide details of 2 referees from people you have previously worked with in a care role

We accept references from :

• Any previous nursing or care employer
• A Senior Care, Team Leader, Registered Nurse or higher
• Up to one nursing or care agency manager

In line with Government legislation under the terms of 'Working Time Regulations' we recommend that your working hours should not exceed 48 hours per week (averaged over a 17 week period). Should you wish to waive this right, please confirm this by selecting below.

Because of the nature of the work for which you are applying , Section 4(2), and further Orders made by the Secretary of State under the provision of this section of the Rehabilitation of Offenders Act (1974) (Exceptions) Order 1975 apply. Applicants are therefore required to give information about convictions which for other purposes are “spent” under the provisions of the Act. Any information given will be completely confidential and will be considered only in relation for positions to which the order applies.

Failure to declare any spent, unspent convictions, cautions, reprimands, or warnings which are not protected may well disqualify you from appointment, or result in your appointment being terminated when the discrepancy comes to light.

By registering on this website and providing your contact details you agree to us contacting you about our services. You consent to Nurse24 passing on your personal data to potentials employers & regulatory bodies for auditing requirements relevant to your profession. You have the right to withdraw your consent at any time and the right to request a copy of your personal data by contacting gdpr@nurse24.uk

Temporary work dictates the need for quick, effective communication for us to secure assignments for you. It is therefore essential for us to maintain regular contact with you across multiple channels. This includes; phone, Email, SMS and in-app push notifications (where applicable). Your consent is required for us to do so.

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.

I authorise Nurse24 to disclose any convictions declared in this registration document to any potential employers in accordance with the DBS Code of Practice and the Rehabilitation of Offenders Act.

By selecting 'YES' below I confirm that I have read and understood the Terms of Engagement and the terms of the declaration and agree to be bound by them.