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Staff Nursing
3rd Floor Lanyon Building Annex
Jennymount Business Park
14 North Derby Street
Belfast
BT15 3HN

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Contact

 jackie@staffnursing.co.uk

General Enquiries:
(028) 9074 5481
Shift Requests:
(028) 9074 4356

On Call

24hour On Call Service:
077323 04526

Privacy

Office Hours

Monday - Friday: 8am - 5pm
Saturday - Sunday: 9am - 5pm

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ADDRESS
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CONTACT DETAILS
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EMERGENCY CONTACT DETAILS
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VISA / WORK PERMIT
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Yes
No

If the answer is no please complete the section below.

Yes
No
Yes
No
Yes
No

PROFESSIONAL BODIES & INDEMNITY
Yes
No

REHABILITATION OF OFFENDERS ACT 1974

By virtue of the Rehabilitation Act 1975 (Exemptions) Order 1975, the provisions of Sections 4.2 of the Rehabilitation of Offenders Act 1974 do not apply to any employment which is concerned with the provision of health services and which is of such a kind as to enable the holder to have access to persons in receipt of such services in the course of his/her normal duties.

It is therefore not contrary to the act for referees to state any criminal convictions that would otherwise be considered as spent.

Please note Policy 0813/63 (Recruitment and Employment of Ex-Offenders) – copy available on request

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Yes
No
Yes
No
 (for example charged or summonsed but not yet dealt with)

Access NI operates under the provisions of Part V of the Police Act 1997. All healthcare workers will be asked to apply for an Access NI Enhanced Disclosure as part of the recruitment and selection process. The cost of this is £32 and is the responsibility of the applicant. Any additional information relevant after commencement of employment must correspond to Staff Nursing.

Staff Nursing has policies on 1the Recruitment of Ex-Offenders and 2the Secure Use, Handling, Storage, Retention, and Disposal of Information. Both are available on request. A criminal record is not a bar to employment and may not exclude you from being offered membership with Staff Nursing.

The ACCESS NI CODE of PRACTICE (May 2018) has been made available to me by clicking link below:
Access NI code of practice???????

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Yes
No
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EDUCATION
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Dates attended - to & from

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Employment history

Please complete details of ALL your employment history in chronological order, starting with your present. (Any gaps in employment must also be listed, and reasons why noted)

Employer 1

Dates to and from

  
  

Employer 2

Dates to and from

  
  

Employer 3

Dates to and from

  
  

Additional Employment History

Please upload your CV or send details of further employment history


REFERENCES

Reference/Referee details – one must be your current or most recent employer

Reference 1

Yes
No

Reference 2

Yes
No

By submitting this application, you consent to Staff Nursing holding your information for 18 months, we may consider you for suitable positions including different areas should they become available. You have the right to consent or object to this.

When uploading documents please ensure total file size is under 10mb
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