vacancy-application-form What position are you applying for:What position are you applying for:Nurses RN & RMNHealthcare Assistants & Support WorkersHousekeeping & CleanersEstate & Management AssistantsStep 2: Personal Details ForenameSurnameDate of Birth *Month *Day *Year *Address Line 1Address Line 2 *Town Or CityPostal CodePrimary Telephone Number *Secondary Telephone Number *Do you hold a current full driving licence?Do you hold a current full driving licence?YesNoUpload image of Driving LicenceChoose FileNo file chosenDelete uploaded fileStep 3: Work Eligibility Are you legally eligible for employment in the UK? *Are you legally eligible for employment in the UK?YesNoDo you have any endorsements in your passport which would limit your stay or length of employment in the UK? *Do you have any endorsements in your passport which would limit your stay or length of employment in the UK?YesNoStep 4: Employment HistoryStep 3: Work EligibilityName of Current employerAddressDate employment commenced:MonthDayYearDate left if applicable:MonthDayYearPeriod of notice requiredPlease give a brief description of your duties in your present or previous employmentCV UploadChoose FileNo file chosenDelete uploaded filePlease give the name & address of two referees.One of these must be your current or most recent employer/ education tutor and neither can be friends or relatives.Referee 1 NameReferee 1 Telephone NumberReferee 1 EmailReferee 1 Position HeldReferee 2 NameReferee 2 Telephone NumberReferee 2 EmailReferee 2 Position HeldStep 5: REHABILITATION OF OFFENDERS ACT (1974)The nature of the work for which you have applied involves direct contact with people who are receiving a health service. We are obliged to ask you, in connection with this application, to disclose any convictions you may have, under the conditions of the above order, you are not entitled to withold information about convictions which otherwise might be considered ‘spent’. Failure to disclose such information could result in dismissal or disciplinary action. Any information given will be treated as strictly confidential and will be used in relation to an application for positions to which the exceptions order applies.Do you have any criminal convictions? *Do you have any criminal convictions?YesNoIf yes please provide details of date of offence and manner of offenceAre you aware of any criminal proceedings against you? *Are you aware of any criminal proceedings against you?YesNoIf yes please provide details of date of offence and manner of offenceStep 6: EQUAL OPPORTUNITIES POLICY STATEMENTMavimm Healthcare Ltd is an equal opportunities employer, the aim of the company’s policy is to ensure that no job applicant or employee will be discriminated against on the grounds of sex, race, ethnic origin, colour, religion, disability, marital status or sexual orientation. The company will ensure whenever possible that no employee or potential employee is disadvantaged by requirements which cannot be shown to be justified. If you believe that the policy described above has not been applied fairly in your case and your case and you wish to pursue the matter, please write in the first instance to:The Director, Mavimm Healthcare, 13 Paynell Close, CV6 4EH, Coventry West Midlands, United KingdomTick here to confirm you have read and understood our Equal Opportunities StatementDECLARATION I declare that the information I have given in this form is true and accurate. I am prepared to undergo a medical examination if required. I also give my consent for my medical records from my current/last employer to be forwarded to Mavimm Healthcare. Tick here to confirm you have read and understood this Declaration:I am happy to receive further marketing contact from Mavimm HealthcareSUBMIT