International Application Form – Mighty Healthcare

Step 1 of 10

Personal Details

Please ensure that you complete the application form in full. This form will be kept in confidence. Please note that no applicant will be unfairly discriminated against. This includes discrimination on account of age, cultural/religious/political beliefs, disability, ethnicity, gender, race, relationship status, sexual orientation, and/or Trade Union membership or stewardship.

Position applied for:*

Preferred employment type*

Part Time

Full time

Surname

First name(s)*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone number (home):

Telephone number (mobile):*

Email address*

Do you have a Driving Licence?*

Yes

How long has your licence been held?

Country where licence was issued:

Are you a United Kingdom (UK), European Community (EC) or European Economic Area (EEA) National ?*

Yes

Date of birth*

National ID number:*

Passport number:

Upload National ID*

Drop files here or

Max. file size: 10 MB, Max. files: 3.

Upload Passport*

Drop files here or

Max. file size: 10 MB, Max. files: 3.

Are you are related to a member of staff or Service User at Mighty Health Care Limited?*

Yes

Name of Person

Relation

Next of Kin

Name*

Relation*

Mobile Number*

Email address*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Equality Act 2010

Under the Equality Act 2010 the definition of disability is if you have a physical or mental impairment that has a “substantial” and “long term adverse effect” on your ability to carry out normal day-to-day activities. Further information regarding the definition of disability can be found at: www.gov.uk/definition-of-disability-under-equality-act-2010.

For the purposes of this application and the interview stage only, is there anything you would like us to be aware of so that we can make reasonable adjustments during the process?

Yes

Prefer Not Discuss

If you have any special requirements to support you to complete this form (e.g. the need for large print or additional time) please contact us on +44 (0) 2921 780 020