Adam Finlay Recruitment Solutions
Candidate Registration
register with us
Submit your application through our secure submission form.
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Email
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Confirm Email address
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National Insurance Number (if applicable)
Passport Number
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Residence Card No.
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Post applied for
Are you permitted to work in the United Kingdom?
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Yes
No
I require a work permit
Surname
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First Name
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Year Moved to Address
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Country code
Mobile Number
Country of Birth
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Name
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First
Last
Job Title
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Organisation
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Email
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Capacity in which they know you
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(e.g. Line Manager)
Telephone Number
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Include country code
Dates Employed From
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Dates Employment Ended
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May we contact this reference prior to interview?
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Yes
No
Name
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First
Last
Job Title
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Organisation
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Email
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Capacity in which they know you
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(e.g. Line Manager)
Telephone Number
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Include country code
Dates Employed From
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Dates Employment Ended
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May we contact this reference prior to interview?
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Yes
No
Have you ever?
Entered the country that you wish to relocate to illegally.
Remained in the country that you wish to relocate to beyond the validity of your visa or permission to stay
Breached the conditions of your leave, for example, worked without permission
Given false information when applying for a visa, leave to enter, or leave to remain
Breached the country that you wish to relocate to immigration law in any other way
None of the above
For the country that you wish to relocate to, have you ever been.
Refused a visa by from the country
Refused entry at the border
Refused permission to stay or remain
Refused asylum by from the country
Been deported removed from the country
Been removed from the country
Required to leave removed from the country
Excluded or banned from entry into the country
None of the above
Have you passed an approved English language test?
Yes
No
English test name
Score achieved
Have you obtained or will you be able to obtain a Police Clearance Certificate? *
Yes
No
Why not?
Qualifications Name & Title 01
Qualifications Name & Title 02
Qualifications Name & Title 03
Qualifications Name & Title 04
Qualifications Name & Title 05
Date 01
Date 02
Date 03
Date 04
Date 05
Grade 01
Grade 02
Grade 03
Grade 04
Grade 05
Institute Name 01
Institute Name 02
Institute Name 03
Institute Name 04
Institute Name 05
Course title 01
Course title 02
Course title 03
Course title 04
Course title 05
Date 01
Date 02
Date 03
Date 04
Date 05
Training provider 01
Training provider 02
Training provider 03
Training provider 04
Training provider 05
Employer’s Name
Employment Dates
Start Date and End Date
Job Title
Reason for Leaving
Notice Required Date
Employer’s Name
Employment Dates
Start Date and End Date
Job Title
Reason for Leaving
Employer’s Name
Employment Dates
Start Date and End Date
Job Title
Reason for Leaving
Employer’s Name
Employment Dates
Start Date and End Date
Job Title
Reason for Leaving
Please tick to show your agreement to this.
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Agree
If you have previously applied to us for work, when did you apply and what was the vacancy?
If yes, what was the outcome?
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At any time have you ever had any of the following, in any another country?
A criminal conviction
A penalty for a driving offence, for example disqualification for speeding or no motor insurance
An arrest or charge for which you are currently on, or awaiting trial
A caution, warning, reprimand, or other out-of-court penalty
A civil court judgment against you, for example for non-payment of debt, bankruptcy proceedings
None of the above
If so, what was the offence? Also provide date.
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Name
*
First
Last
Signature
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Type your full name to confirm as your signature
Declaration
I fully accept that I am applying for Employment with the knowledge and understanding as per the job description and interview process.
I declare that all the information given is true and I understand that any false or misleading information may result in my removal from Adam Finlay Healthcare Recruitment Solutions register of applicants. I consent to the processing of sensitive personal data as referred to on this form.
If your application and you are granted a visa as Skilled Worker, there will be conditions on your visa or leave to remain. This will include, for example who you work for and what your job is going to be.
I understand that if false information is given, the application for visa can be refused and I may be prosecuted, and, if I am the applicant, I may be banned from the country.
Name
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First
Last
Signature
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Type your full name to confirm as your signature
1. Are you currently bound over or have you ever been convicted of any offence by a Court or Court-Martial in any country? Note: You do not need to tell us about parking offences
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Yes
No
If YES, please include details of the order binding you over and/or the nature of the offence, the penalty, sentence or order of the Court, and the date and place of the Court hearing.
2. Have you ever received a police caution, reprimand or final warning?
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Yes
No
If YES, please include details of the caution, reprimand or final warning, including the date and reason administered.
3. Have you been charged with any offence in any country that has not yet been disposed of?
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Yes
No
Please note:
you must inform us immediately if you are charged with any offence in any country after you complete this form and before taking up any position offered to you.
You do not need to tell us if you are charged with a parking offence.
If YES, please include details of the nature of the offence with which you are charged, date on which you were charged, and details of any on-going proceedings by a prosecuting body.
4. Are you aware of any current police investigation in the United Kingdom or in any other country following allegations made against you?
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Yes
No
If YES, please include details of the nature of the allegations made against you, and if known to you, any action to be taken against you by the police.
5. Are you aware of any current Counter Fraud and Security Management Service investigation following allegations made against you?*
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Yes
No
If YES, please include details of the nature of the allegations made against you, and if known to you, any action to be taken against you.
6. Have you ever been investigated by the Police or any other Investigatory Body resulting in a caution, conviction or dismissal from your employment? (Investigatory bodies include Local Authorities, Customs and Excise, Immigration, Passport Agency, Inland Revenue, Department of Trade and Industry, Department of Work and Pensions, Security Agencies, Financial Service Authority, Banks and Building Societies, General, Life Insurance Companies.
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Yes
No
This list is not exhaustive, and you must declare any Investigation conducted by an Investigatory Body.
If YES, please include details of the nature of the allegations made against you, and if known to you, any action to be taken against you by the Investigatory Body.
7. Have you ever been dismissed by reason of misconduct from any employment, office or other position previously held by you?
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Yes
No
If YES, please include details of the employment, office or position held, the date that you were dismissed and the nature of allegations of misconduct made against you.
8. Have you ever been disqualified from the practice of a profession, or required to practice subject to specified limitations following fitness to practice proceedings, by a regulatory or licensing body in the United Kingdom or in any other country?
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Yes
No
If YES, please include details of the nature of the disqualification, limitation or restriction, the date, and the name and address of the licensing or regulatory body concerned.
9. Are you currently the subject of any investigation or fitness to practice proceedings by any licensing or regulatory body in any country?
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Yes
No
If YES, please include details of the reason given for the investigation and/or proceedings undertaken, the date, details of any limitation or restriction to which you are currently subject, and the name and address of the licensing or regulatory body concerned.
10. Are you subject to any other prohibition, limitation, or restriction that means we are unable to consider you for the position for which you are applying?
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Yes
No
If YES, please include details of the nature of the prohibition, restriction, or limitation, when and by whom it was made.
Name
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First
Last
Signature
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What is your ethnicity?
Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong.
Do you consider yourself to have a disability or health condition?
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Yes
No
Prefer not to say
What is the effect or impact of your disability or health condition on your work?
What is Your Religion or Belief?
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No religion or belief
Buddhist
Christian
Hindu
Jewish
Muslim
Sikh
Prefer not to say
If other religion or belief
Submit