Dear Candidate
Please find enclosed an application pack for the above position.
Once you have completed the application form please return to:
Maria Tickner
Relief Staff Co-ordinator
Family Mosaic
Pembroke House
Northlands Pavement
Pitsea
Essex SS13 3DU
Unfortunately we are unable to respond to all applicants. If you have not heard from us within 4 weeks of the submission of your application form then I am afraid this means you have not been successful on this occasion.
Kind regards
Maria Tickner
Relief Staff Co-ordinator
Direct Line: 01268 499219 Fax: 01268 498587
Email: maria.tickner@familymosaic.co.uk
FM Logo RGBAPP. No.
APPLICATION FOR EMPLOYMENT
This form will need to be photocopied. Please write clearly in BLACK INK.
Please complete this form in full and return to:
Maria Tickner, Family Mosaic, Pembroke House, Northlands Pavement, Pitsea, Essex SS13 3DU
Maria.tickner@familymosaic.co.uk
CVs will not be acceptedwww.familymosaic.co.uk
POST APPLIED FOR: Qualified Nurse (Relief) | REF: |
1. PERSONAL DETAILS Surname | First Names | Address Postcode National Insurance No. | Telephone: Mobile Evening Day Email |
2. SECONDARY AND FURTHER EDUCATION All candidates who are shortlisted for interview may be required to provide certificates or qualifications as detailed below | Name & Address of Schools attended | From | To | Qualifications | Grade/ Result | Date | Name & Address of College/University | | | | | | Membership of Professional Bodies Membership No: Date Admitted: |
3. PRESENT AND PAST EMPLOYMENT DETAILS (Current or most recent first. Please include any period of unemployment or explain gaps in your work history.) Employer/Employers’ Address | Position held Give a brief description of your duties |