JOB APPLICATION FOR KING'S PHLEBOTOMISTS by a282102

VIEWS: 93 PAGES: 2

									                                                      QuickTime™ and a
                                                       decompressor
                                               are needed to see this picture.




                                               Application Form
FULL NAME


ADDRESS

Date Of Birth                                                            EMAIL ADDRESS

                                                                                 MOBILE
HOUSE NUMBER
                                                                                 NUMBER
N. I. NUMBER
A phlebotomy training certificate OR a reference from an employer stating your
venipuncture and vacutaniner technique competency need to be provided: (please indicate
which one you are going to provide, delete as appropriate)

Phlebotomy training certificate: Y/N              OR         Reference: Y/N
Do you have any experience of collecting blood from the umbilical cord, if so please give
detail below:
Y/N


Do you have an upto date Criminal Record Bureau (CRB):

Y(please provide a copy)/N
Are you upto date with your Immunisations?                              Y/N
Do you own a car? Y/N
Maximum mileage that you are willing to travel away from home:

------------------miles
Name areas you are able to cover:

-------------------------------------------------------------------------

-------------------------------------------------------------------------

-------------------------------------------------------------------------

-------------------------------------------------------------------------




            King’s Phlebotomists is the trading name of Sabir Noory Ltd. Company Registration Number: 06998104
                REGISTERED OFFICE ADDRESS: 27 Fordington House, Sydenham Hill, London SE26 6TX
             Mobile: 07855 278 785 Email: info@kingsphlebotomists.co.uk Web: Kingsphlebotomists.co.uk
Hospitals in your area that you would like to attend? (Please list below)

-------------------------------------------------------------------------

-------------------------------------------------------------------------

-------------------------------------------------------------------------

-------------------------------------------------------------------------

Please write which days of the week and hours you are available on call?

-------------------------------------------------------------------------

--------------------------------------------------------------------------

Two passport sized photographs provided? Y/N



           PLEASE POST OR EMAIL US COPIES OF YOUR CRB,
              PHLEBOTOMY CERTIFICATE/REFFERENCE,
        IMMUNISATION HISTORY AND 2 PASSPORT PHOTOGRAPHS
                         WITH THIS FORM




            King’s Phlebotomists is the trading name of Sabir Noory Ltd. Company Registration Number: 06998104
                REGISTERED OFFICE ADDRESS: 27 Fordington House, Sydenham Hill, London SE26 6TX
             Mobile: 07855 278 785 Email: info@kingsphlebotomists.co.uk Web: Kingsphlebotomists.co.uk

								
To top