Job Application Form

Personal Details

Education & Training


Full Employment History

Please cover full employment history with any gaps explained. Please provide us with the Name and address of employer, your position held, your start and end date and the reason for leaving.Please start with your current employment first.


Due to the nature of the role you have applied for we need to carry out a complete new starter health questionnaire- even if you have been employed in the UK health services before. The health of each candidate is considered individually and a decision regarding fitness for work in the prospective job role will be based on the functional effects of any underlying health condition/disability/impairment as well as health service requirements for fitness and immune status

Do you, or have you ever suffered from any of the following?

Have you had any of the following immunisations


Please give your current or most recent employer. Both references must be from previous employment. References from personal emails will not be accepted.


Please give work address only


Please give work address only


Due to the nature of the work which is offered by Rapid Response Secure Ambulance Ltd, this post is exempt from the provisions of section 4(2) of the Rehabilitation of offenders act (1974) (Exemptions) (Amendments) order 1986. This means that applicants cannot withhold information about convictions (whether or not the have been 'Spent' under the Act). PLEASE NOTE A conviction does not automatically stop you from registering.

I confirm that the information on this form is correct and complete to the best of my knowledge

The General Data protection Regulation (GDPR) (EU) 2016/679

All information supplied by you will be held in confidence by Rapid Response Secure Ambulance Ltd. Records will be retained electronically and on personal file in accordance with best practice and the requirements of the GDPR at which time may be subject to audit. Your data may be required to be seen by our Stakeholders, Clients, Auditors, Managers, HR Advisors, Occupational Health as part of Compliance Requirements without your explicit consent. You have the right of erasure (the right to be forgotten), withdrawal of consent and refusal of consent without detriment. The only exceptions to this may be a court order for release of records in judicial dispute or where there is a public responsibility obligation.