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									Registrations Centre Officer
Application form

This form is to be accompanied by:
Recruitment Monitoring Form

SECTION 1 of 7: Personal details
Surname:                                        Forename(s):

Address:                                        Telephone number:

                                                Mobile number:

                                                Email address:

SECTION 2 of 7: Declaration

To the best of my knowledge and belief the information given in this form is correct. I understand
that if I am appointed and this information is inaccurate, I am liable for dismissal.

Signature:                                                 Date:

Please tell us which vacancy you are interested in:
   permanent role (1 available)             10 week fixed term contract (8 available)
Please tell us where you heard about this vacancy:
   NMC Website         Total Jobs           Reed                   Other (Specify),

   NMC Employee         Name of employee:

                                                                                        Page 1 of 4
Registrations Centre Officer                                                  For NMC use only
Application form                                                              Applicant:

 SECTION 3 of 7: Abilities and experiences
 Having familiarised yourself with the job description and person specification for this role,
 please give us about two or three examples on your ability/experience in each of these areas.
 Experience of working in a customer service environment, preferably a call/advice centre

 Good IT skills with experience of data input and the retrieval of information using databases

 Ability to relay complex information in a way that is easy to understand

 Sensitivity and tact when identifying and working with customer needs

                                                                                   Page 2 of 4
Registrations Centre Officer                                                      For NMC use only
Application form                                                                  Applicant:

 SECTION 4 of 7: Entitlement to work in the UK
 In order to comply with the Asylum and Immigrations Act 1996 we are required to ask you to verify
 your entitlement to work in the UK
 Are you legally entitled to work in the UK?
                                                                                  yes            no
 Do you need a visa or work permit to work in the UK?
                                                                                  yes            no
 If Yes please give details including expiry date and any restrictions:

 SECTION 5 of 7: Criminal convictions
 Have you ever been convicted of a criminal offence? (Declaration subject to
                                                                                  yes           no
 the Rehabilitation of Offenders Act 1974)
 If yes please give details:

 SECTION 6 of 7: Current salary
 Please state your current or most recent salary:

 SECTION 7 of 7: References
 Please provide below your two most recent employment details. References will only be collected
 for successful applicants and with your consent.
 Reference 1                                      Reference 2
 Employment dates:                                Employment dates:
 Company name:                                        Company name:
 Company full address:                                Company full address:

 Telephone number:                                    Telephone number:
 Email address:                                       Email address:
 Contact name:                                        Contact name:
 Contact job title:                                   Contact job title:

                                                                                        Page 3 of 4
Registrations Centre Officer                                                    For NMC use only
Application form                                                                Applicant:

Returning your application

Please return your completed application form, together with a copy of your CV and the NMC
recruitment monitoring form, by email to

For any application related queries, please contact a member of the HR and OD team on Thank you for your interest in a position at the NMC.

                                                                                     Page 4 of 4

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