Register – Nurse24™

Registration Form
What job role are you applying for ? *

Registered Nurse Senior Healthcare Assistant Healthcare Assistant Support Worker
Your Title *

Mr Mrs Ms Miss Dr
Your First Name *
First Name
Middle Name
Middle Name
Your Last Name *
Last Name
Date of Birth *

Day Month Year
National Insurance Number *
Home Address *

Street Address

Street Address Line 2

City County

Postcode
Email Address
example@example.com
Mobile Number *
Enter your mobile number

NMC PIN (Registered Nurses Only)

.
If you are not able to provide your NMC PIN now, you can provide it later. This will be required to complete your compliance later on.
NMC PIN Number
NMC PIN expiry Date

Day Month Year
Eligibility for employment
What is your Nationality? *
What is your Right to Work Status? *

UK Passport Tier 1 Tier 2 Tier 4 Tier 5 Indefinite Leave Ancestral Visa

Next of Kin
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.
Full Name *

First Name Last Name
Relationship & Contact number *

Next of Kin relationship to you Next of kin contact Number

Employment History
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.
Upload Your CV

Cancel of
If you do not have a current CV, please enter your employment history below
Explain any Gaps of more than three months below:
Mandatory training
Do you have a current basic life support certificate? *

Yes No
Do you have a current moving and handling certificate? *

Yes No

Registration Form