Employment Application
Please complete the form below accurately indicating your potentials and suitability to job applying for.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
County
Post Code
Birth Date
*
Please select a day
1
2
3
4
5
6
7
8
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10
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31
Day
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
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2009
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1931
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1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Email
*
example@example.com
Contact Phone Number
*
-
+44
Phone Number
Do you have the right to work in the UK?
*
Please Select
Yes
No
NI Number
If you do not hold a British Passport - Please provide share code or resident permit.
Back
Next
Have you held a current full UK (manual) driving licence for at least 3 years?
*
Please Select
Yes
No
Do you have any endorsements/ points on your licence?
*
Yes
No
Have you any motoring convictions?
*
Yes
No
If you have answered YES to either of the last two questions, please provide detail including rates and reasons.
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Next
Clinical Grade
*
Please Select
Doctor
ECP / ENP / Paramedic Practitioner
HCPC Paramedic
NMC Nurse
IHCD / NHS Technician/ AAP
ECA / ECSW
Emergency responder / First Responder
Student Paramedic
If applicable, please enter professional body registration.
HCPC/NMC
Please upload Medical Qualification Certificate:
*
Upload a File
Drag and drop files here
Choose a file
i.e. FREC4, Paramedic degree
Cancel
of
Back
Next
Please upload Passport
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload Driving Licence - Front and Back
Browse Files
Drag and drop files here
Choose a file
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of
Please upload Proof of address
*
Browse Files
Drag and drop files here
Choose a file
i.e. bank statement or utility bill dated within 3 months
Cancel
of
Please upload Blue Light Driving Certificate:
Browse Files
Drag and drop files here
Choose a file
i.e. IHCD or CERAD
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of
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Next
Please upload current CV
*
Browse Files
Drag and drop files here
Choose a file
Must include employment history of 10 years
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of
Gaps in Employment History
Please provide reason and date for any gaps in employment history.
Please upload DBS certificate
Browse Files
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Choose a file
Must be on the update service
Cancel
of
Are you subscribed to the update service with the DBS certificate uploaded?
Yes
No
Please upload mandatory training certificates:
Browse Files
Drag and drop files here
Choose a file
Infection Control, Information Governance, Fire Safety, Manual Handling E-Learning, Equality & Diversity, Health & Safety, Conflict resolution, Prevent, Safeguarding Adults - Level 3, Safeguarding Children - Level 3, Safeguarding Delivery F2F, Dementia Awareness.
Cancel
of
Back
Next
How did you hear about LMS?
*
Referral
Facebook
LinkedIn
Other
Declaration
I declare that the information given in this form, and any supplementary documentation, is complete and accurate. I understand that any false information or deliberate ommision will disqualify me from this application process or may render me liable for summary dismissal. I understand these details will be held in confidence by the Company in compliance with Data Protection Act 2018 and GDPR. I also understand that the application form may be shared with our customers, in confidence, if required.
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