07873476333 contact@cranemedicalcare.co.uk

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Title

First name

Surname

Date of Birth

Mobile Number

Home Address

National Insurance Number

Emergency Contact Details

Full Name

Relationship

Address

Telephone Number

Qualifications and Documents

PLEASE NOTE: If you are unable to upload documents at this time, please ensure you do the following:

- Complete the application and email your documents to HR@cranemedicalcare.co.uk

- Email HR@cranemedicalcare.co.uk detailing the documents you do not have, in order to receive support in attaining them.

Those who upload their documents with this form will be prioritised for interviewing.

Please detail all medical qualifications below, (if none please state - 'none but willing to do relevant training')

Please Upload your qualification certificates below: (Please note, we can only accept Word documents, PDFs or Images)

Please detail any other qualifications you have:

Please Upload your qualification certificates below: (Please note, we can only accept Word documents, PDFs or Images)

Do you have an enhanced DBS?

Yes

If you selected Yes, is this on the Update Service?

Yes

If yes, please upload your Enhanced DBS disclosure (all pages) OR email us at HR@cranemedicalcare.co.uk stating to us that you will send it to us at a later date. If you have one and it is not sent, you will not proceed to the interview.

Upload CV

Why would you like to work with Crane Medical Care?

Why you would like to join Crane Medical Care and why you consider yourself suitable for the role of First Aider. Any summary of relevant experience and timescales.

Please provide the following documentation: 1.Original proof of your right to work in the UK is essential and will be required in advance of starting your employment (e.g. Passport or Driving Licence) 2.Photo for ID Card

Equal Opportunities

Gender

Nationality

Do you consider yourself disabled?

Yes

Prefer not to answer

If Yes - Please tick below which category your disability falls within:

References: 2 references are required (One personal and one employer)

Sometimes it may be appropriate for us to contact your referees before you undertake an interview with us, please can you indicate below your wishes on whether we can contact this referee in advance.

Yes

Reference 1 (Professional) Please provide all 3 of name, role and email address

Reference 2 (Personal) Please provide all 3 of name, role and email address

Status of employment

Self-employed status / Tax and National Insurance (or similar contributions) Liabilities

Crane Medical Care and the Contractor (staff member) declare and confirm that it is the intention of the parties that the Contractor shall have the status of a self-employed person and shall be responsible for all income tax liabilities and national insurance or similar contributions in respect of his/her fees. Accordingly the Contractor hereby agrees to indemnify Crane Medical Care in respect of any claims that may be made by relevant authorities against Crane Medical Care in respect of income tax and national insurance or similar contributions relating to the Contractor's services under this contract.

Data Protection

Crane Medical Care and the Contractor (team member) agree to comply with all applicable data protection legislation, including but not limited to the General Data Protection Regulations (GDPR).

Employment

Crane Medical Care declare nothing in this contract shall render or be deemed to render the Contractor (team member) an employee or agent of Crane Medical Care and the Contractor hereby agrees that he/she is a self employed independent contractor and not an employee or agent of Crane Medical Care.

This contract does not create any mutuality of obligation between Crane Medical Care and the Contractor.

Declaration of Employment Status

I declare the above information has been explained to me clearly and to the best of my knowledge, I understand this information and my status as a self employed person and my accountability in relation to Income Tax and National Insurance Liabilities.

I agree to this declaration

I do not agree to this declaration

Full name

Please enter the date in which you signed this declaration

I declare I have provided true and accurate information in this application form:

I agree to this declaration

I do not agree to this declaration

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