Notes to Candidates

NHS Scotland Application Form /
Notes to candidates

1How to complete this form

First save this form under the Vacancy Reference Number which starts IRC. Enter data in the non-shaded fields, adding a separate sheet if required. Additional guidance for applicants is included under section headings throughout this application form.

You must complete this application form in full, as we DO NOT ACCEPT OR PROCESS curricula vitae (CVs).

CV’s received shall be disregarded and application removed from the Vacancy.

2How we handle this information

All information collected and processed by NHSScotland is regarded as highly confidential, and is handled in line with the Data Protection Act. (Please note, however, that we are only responsible for handling of your information once we have received it.)

• Part C (Education; Employment History) of this form will be used for the first stage of selection for interview.
• If selected for interview,Parts A and C will be made available to those involved in the interview process.

NHSScotland intends that recruitment practice will comply fully with our legal duties on equality. This will ensure that nothing in our recruitment process and practice will discriminate against, victimise or harass job applicants on the grounds of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex or sexual orientation, and/or Trade Union membership or stewardship.

Part A
Application for (Job Title):
Vacancy Reference No.:
(e.g. IRC1234)
Statutory Registration & Professional Membership details
Include in this section any relevant professional registrations or membership. This information will be subject to a satisfactory check. Please continue on a separate sheet if necessary.
Category:
E.g.:
Statutory Registration
Non-Statutory Registration
License
AHP Practice Educator
Professional Membership
NMC Mentorship
Type:
Date Received (month & year):
License Number:
Category:
Type:
Date Received (month & year):
License Number:
Category:
Type:
Date Received (month & year):
License Number:
Category:
Type:
Date Received (month & year):
License Number:
PVG Scheme details
Include in this section details of PVG Scheme membership, if applicable. This information will be subject to a satisfactory check.
PVG Scheme Registration Number:
PVG Registration Date:
PVG Regulatory Group:
Job Interview Guarantee (JIG) Scheme
NHSScotland operates a Job Interview Guarantee, which means that if you have a disability and meet the minimum criteria outlined within the person specification, you will be guaranteed an interview. However, some disabled people prefer not to take this option, so please tick your preference if you are a disabled candidate.
Do you want to participate in the JIG Scheme? / Yes  / No 
Please state any specific requirements if attending interview (e.g. induction loop)
Eligibility to work in the UK
Candidates should note that a Certificate of Sponsorship can only be issued to the successful applicant if the post is either:

• included in the UK Shortage Occupation List; or
• meets the requirements of the resident labour market test.

Do you need to be sponsoredunder the Tier 2 (General) category of the UK points-based immigration system to take up this post? / Yes  / No 
Right to work in the UK (Asylum and Immigration Act 1996)
We must check the right to work in the UK of all candidates appointed. If appointed, as part of our pre-employment checks, you must present original proof and a copy of your Right to Work in the UK. (See
Are you a United Kingdom (UK), European Community (EC) or European Economic Area (EEA) National? / Yes  / No 
If you have answered “No” to the question above, please state the visa category under which you are legally entitled to work in the UK.
What is the expiry date of your leave to remain in the UK?
Where did you see the advert for this job?
NHSS iRec portal /  / Newspaper /  / Please specify:
Vacancy bulletin /  / Professional journal /  / Please specify:
Job Centre Plus /  / Other website /  / Please specify:
Other / Please specify:
Part B
Application for (Job Title):
Vacancy Reference No.:
(e.g. IRC1234)
Applicant No.:
(office use only)
NHS Employment
Are you currently employed in the NHS? / Yes  / No 
Employment History
Enter details of your current, or most recent, employment. Please remember to include the grade and notice period in the “Description of Job Duties” box. If a job supports the position you are applying for, please say more about it in your “Statement in Support of Application”.
Employer:
Start Date:
End Date:
Job Title:
Location:
Description of Job Duties (including grade and notice period)
Employment history
Add all previous periods of employment here. Please continue on a separate sheet if necessary.
Please include and give a brief explanation of any periods of unemployment.
Employer:
Start Date:
End Date:
Job Title:
Location:
Description of Job Duties (including grade and notice period)
Employer:
Start Date:
End Date:
Job Title:
Location:
Description of Job Duties (including grade and notice period)
Employer:
Start Date:
End Date:
Job Title:
Location:
Description of Job Duties (including grade and notice period)
Employer:
Start Date:
End Date:
Job Title:
Location:
Description of Job Duties (including grade and notice period)
Qualifications
Please enter details of the colleges and universities which you have attended as well as the qualifications received. DO NOT enter the name of the secondary school you attended. Please enter the word SCHOOL only in the college/university field for secondary school qualifications. Please continue on a separate sheet if necessary.
Qualifications ACHIEVED
College or University:
Location:
Qualification:
Major subject:
Date Received:
College or University:
Location:
Qualification:
Major subject:
Date Received:
College or University:
Location:
Qualification:
Major subject:
Date Received:
Qualifications CURRENTLY WORKING TOWARDS
Subjects / Type of qualification / Grade anticipated / Date anticipated
Work-related training ACHIEVED (accredited or non-accredited)
Course title
(e.g. ECDL) / Qualification or accreditation / Grade Achieved
(if applicable)
Work-related training CURRENTLY WORKING TOWARDS
Course title / Qualification / accreditation / Grade anticipated / Date anticipated
Statement in Support of Application
Please tell us about your personal qualities, skills and attributes, experience and any major achievements, and show how they match those identified in the job description and person specification for this post.
References
Our pre-employment screening includes taking up references and, where appropriate, health and fitness for work, criminal records, immigration status, qualifications and professional registration.
Your referees must include your present (or most recent) employer. Please identify below the person in your organisation (this is normally your direct line manager) who is authorised to confirm your employment and the details given in your application. Please also identify a second referee who may have close knowledge of your skills, knowledge and abilities, and who may offer opinion on your suitability for this post (e.g. supervisor or previous employer).
You should not use family members or friends. Your referees should cover a minimum three-year period, so please provide details on a separate sheet of more than two referees if necessary.
References will only be taken up for preferred candidates after interview, and we recommend that at that stage you contact your referee direct to advise that they will be receiving a reference request.
Name of referee (1):
Referee’s job title:
Referee’s address and postcode:
Referee’s telephone number:
Referee’s e-mail address:
In what capacity is this reference being provided? (e.g. employment; academic etc)
Name of referee (2):
Referee’s job title:
Referee’s address and postcode:
Referee’s telephone number:
Referee’s e-mail address:
In what capacity is this reference being provided? (e.g. employment; academic etc)
Name of referee (3):
Referee’s job title:
Referee’s address and postcode:
Referee’s telephone number:
Referee’s e-mail address:
In what capacity is this reference being provided? (e.g. employment; academic etc)
Part C
Declarations
Convictions
Certain posts in NHSScotland are exempt from the 1974 Rehabilitation of Offenders Act (Exclusions & Exceptions) (Scotland) Order 2003. This means that unless stated in the job description, person specification or application pack, you must tell us about any previous convictions, classed as either “spent” or “unspent”.
If you are offered employment, any failure to disclose such convictions could result in dismissal or disciplinary action. Any information you give will be considered only in relation to the post for which this application form refers. Information will be verified by Disclosure Scotland for relevant posts.
I declare that I have:
 No previous convictions
OR
 Previous convictions, details of which are:
Internal candidates:
Please be aware that the information that you provide as part of your application will update your personal record on the electronic Employee Support System (eESS). If any information you have provided is found to be inaccurate, this will be investigated and may be addressed through the Board’s Disciplinary/Conduct policy, which may include dismissal.
All candidates:
Please read the following statements. (If you submit your application electronically, you will be asked to sign your application form if you are short-listed and attend for interview.)

• The details I have supplied in this application are, to the best of my knowledge, true and complete;

• I understand that if appointed to this post, the information on this form will be kept as part of my personal record;

• I authorise you to obtain references to support this application before any final job offer is made;

• I understand that details of educational qualifications, membership of professional bodies, referee reports and immigration status may be verified through the establishments and individuals I have indicated;

• I consent to my details being kept confidentially and used for specific and lawful purposes as specified in the Data Protection Act 1998;

• I declare that I have no previous convictions, or have identified any I have above.

Read, agreed & understood (tick box) / 
Signed: (if applying by paper copy)
Date:

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