Recruitment Application Form Douglas Macmillan Hospice Barlaston Road. Staffordshire. ST3 3NZ t. 01782 344 300 f. 01782 300 344 Please Note: Any separate CV enclosed with this application will not be used during the selection process. Please do not send separate CVs, thank you. Position applied for: 1. Personal Information (All information will be treated as confidential) Title (Dr / Mr / Mrs / Ms / Miss) Other: Home Address: Forenames: Surname (Block Capitals): Postcode: Tel. No. Home / Mobile: address: Tel No. Work: (Please note correspondence will be sent by email where possible) Do you require a work permit? Yes / No Do you hold a current UK Driving Licence? Yes / No Do you have regular use of a car? Yes / No 2. Education and Training General Education / Further Education Level Please specify the name of the school, college or university you E.G. GCSE’s, A-Levels, Degree. attended, including schools of nursing
Recruitment Application Form Douglas Macmillan Hospice Barlaston Road. Staffordshire. ST3 3NZ t. 01782 344 300 f. 01782 300 344 Please Note: Any separate CV enclosed with this application will not be used during the selection process. Please do not send separate CVs, thank you. Position applied for: 1. Personal Information (All information will be treated as confidential) Title (Dr / Mr / Mrs / Ms / Miss) Other: Home Address: Postcode: Forenames: Surname (Block Capitals): Tel. No. Home / Mobile: address: (Please note correspondence will be sent by email where possible) Tel No. Work: Do you require a work permit? Do you hold a current UK Driving Licence? Do you have regular use of a car? Yes / No Yes / No Yes / No 2. Education and Training General Education / Further Education E.G. GCSE’s, A-Levels, Degree. Level Please specify the name of the school, college or university you attended, including schools of nursing
Recruitment-Application-Form-V7.docx