HOW WOULD YOU BEST DESCRIBE YOUR ETHNIC ORIGIN? White:- Asian or Asian British: Chinese or other ethnic group: A British H Indian B Irish J Pakistani R Chinese C Other White K Bangladeshi S Any other L Other background Mixed: Not given: D White and black Black or Black British: Z Caribbean M Caribbean E White and black African N African These classifications F White and Asian P Other black correspond to those used in G Other mixed background the 2001 census WORK EXPERIENCE DETAILS Applications forms are considered according to availability in the area of healthcare you have chosen and the dates you have specified. Therefore we strongly suggest that you consider the wide range of services we offer when completing your application, and submit your application form at least 6 weeks before your specified dates. Area/Department interested in To help Locala review your application, please provide us with your preferred dates. Although we will try to match your proposed dates we cannot guarantee our services will be able to accommodate your request. (We are only able to offer a maximum of 5 working days in order for us to meet the high volume of applications.) Preferred Dates: Only complete this if your placement has been pre-arranged by a member of Locala staff. Area / Placement Dates of your Placement Supervisor / Mentor of your placement with Locala
HOW WOULD YOU BEST DESCRIBE YOUR ETHNIC ORIGIN? White:- A British B Irish C Other White Mixed: D White and black Caribbean E White and black African F White and Asian G Other mixed background Asian or Asian British: H Indian J Pakistani K Bangladeshi L Other background Black or Black British: M Caribbean N African P Other black Chinese or other ethnic group: R Chinese S Any other Not given: Z These classifications correspond to those used in the 2001 census WORK EXPERIENCE DETAILS Applications forms are considered according to availability in the area of healthcare you have chosen and the dates you have specified. Therefore we strongly suggest that you consider the wide range of services we offer when completing your application, and submit your application form at least 6 weeks before your specified dates. Area/Department interested in To help Locala review your application, please provide us with your preferred dates. Although we will try to match your proposed dates we cannot guarantee our services will be able to accommodate your request. (We are only able to offer a maximum of 5 working days in order for us to meet the high volume of applications.) Preferred Dates: Only complete this if your placement has been pre-arranged by a member of Locala staff. Area / Placement Dates of your Placement Supervisor / Mentor of your placement with Locala