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Regulation 12(1)
1. Name, address, date of birth and telephone number.
2. Name, address and telephone number of next of kin.
3. Proof of identity, including a recent photograph.
4. Details of any criminal offences—
(a)of which the person has been convicted, including details of any convictions which are spent within the meaning of section 1 of the Rehabilitation of Offenders Act 1974(1) and which may be disclosed by virtue of the Rehabilitation of Offenders (Exceptions) Order 1975(2); or
(b)in respect of which she has been cautioned by a constable and which, at the time the caution was given, she admitted.
5. Two written references from nurses or other health professionals, including a reference relating to the last period of employment as a nurse of not less than three months duration.
6. Where a nurse has previously worked in a position which involved work with children or vulnerable adults, verification of the reason why she ceased to work in that position, unless it is not reasonably practicable to obtain such verification.
7. Evidence of a satisfactory knowledge of the English language, where the nurse’s nursing qualifications were obtained outside the United Kingdom.
8. Documentary evidence of any relevant qualifications and training.
9. A full employment history, together with a satisfactory written explanation of any gaps in employment and details of any current employment other than for the purposes of the agency.
10. Details of health record, including immunisation status.
11. Confirmation of current registration with the Nursing and Midwifery Council, including details of the Part of the register in which the nurse is registered.
12. Details of any professional indemnity insurance.
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