APPLICATION FORM


Dear Candidate

On the day of your interview, we will need you to bring the following documentation:

  • 2 X validated references (these must be relevant to your area of practice and must be completed by someone senior to your current grade.
  • Application form
  • Signed terms and conditions
  • Up to date CV
  • Educational certificates

Identification and Right to Work documents needed are:
.

  • In date Passport
  • Visa (if applicable)
  • NI proof (NI Card, HMRC Letter or DWP Letter. We cannot accept payslips or P45 as proof of NI).
  • Driving licence
  • 2 X proofs of address (dated within the last 3 months – Electricity/water/gas/landline telephone bill, bank/credit card statement or a council tax bill. Please note – we cannot accept mobile phone bills or TV licences as proof of address.
  • Occupational Health form completed and signed. (Proof of all immunisations from a doctor or from a hospital).
  • DBS certificate. Must be in date or on the update service.
  • 2 X passport sized photos
  • Marriage/Birth certificate or change of name document


If you can bring all of these documentation with you on the day, it will help with the speed and accuracy of your registration.

Kind regards

Nurses Alliance Limited
.

.

Please Complete the form below

.
.

WORKING TIME REGULATIONS:
The Working Times regulations 1998 (”The Regulations”) require Nurses Alliance to limit your average weekly working time to 48 hours, unless you agree with Nurses Alliance that the limit shall not apply to you. DRC Group wishes to have an agreement with you whereby it proposes an agreement (which will apply until terminated notice) on the basis that:
1) The 48 hour limit on average weekly time shall not apply to you.
2) You may terminate the agreement (so that the 48 hour time limit would apply to you) by giving a nominated person at Nurses Alliance your 4 weeks written notice. Under the Regulations, Nurses Alliance must keep records relating to your working time. This is the case whether or not you reach an agreement with Nurses Alliance about waiving working time limits. If you accept Nurses Alliance proposals, please sign below. This document will then be the record of the agreement. You may choose to sign this proposal and Nurses Alliance will not subject you to any detriment if you do not sign it or exercise your right to terminate it.
.
.

.
.

GDPR CONSENT:
I consent to Nurses Alliance using my personal data and sensitive date provided in this application form for the purposes that it has been collected for. The consent I give to the company is for as long as necessary for the purpose it was collected, and once the company no longer need it, it will be deleted or annonymised. I am aware of my right to withdraw my consent at anytime verbally or in writing to Nurses Alliance.
.
.

.
.

DECLARATIONS:​​​​​​​

I declare that I have received, read and understood the Nurses Alliance Limited Handbook/Information pack and agree to abide by the terms and conditions detailed within the handbook.

I consent to Nurses Alliance Limited requesting a Disclosure and Barring Service (DBS) check and understand that any fees associated are payable by myself. I consent to Nurses Alliance Limited requesting a DBS status update on my behalf.

I consent to Nurses Alliance Limited requesting appropriate references on my behalf.
I declare that the information I have given in this application form is true and not in any way intended to mislead. I agree that if I have given false or misleading information or if I do not give relevant information now or in the future, this may result in termination of an assignment and removal from Nurses Alliance Limited register without notice.
I consent to Nurses Alliance Limited to make available my information to third parties for the purpose of audit.

I acknowledge that if any of my details stated on the Application Form change, or my circumstances change in any way which may affect my ability to work for Nurses Alliance Limited. I must inform Nurses Alliance Limited immediately.

I understand that I need to keep any relevant training up to date and should I feel I require further training in my specialty, I will inform Nurses Alliance Limited immediately. I understand that any fees associated are payable by myself.

I confirm that I am not currently under investigation, or currently suspended by any professional regulatory bodies or being investigated by my current or previous employer. I will inform Nurses Alliance Limited immediately if I become under investigation or suspended by any professional regulatory body or employer at any point whilst working for Nurses Alliance Limited.

I declare that by signing this form I am stating that I am legally entitled or allowed to work in the United Kingdom, with or without necessary permission from the Home Office or any other relevant authority if I have secured permission to work. I also acknowledge that if it is found that I am working without the relevant permission, my engagement with Nurses Alliance Limited will be terminated with immediate effect, and all details passed to the relevant authorities.
I understand it is my responsibility to engage in the revalidation process including participating in annual appraisals
.
.

Alternatively, you can download the form here and email it back to admin@nursesalliance.co.uk