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Additional Information Required  - Nurse / Caregiver

Thank you for your recent application for a position as a Nurse or Caregiver.   

To allow us to fairly assess your application, we ask that you complete the following questionnaire.  


At this time, we also require the names and contact details of at least 2 professional references. Your references must know you in a professional capacity.  And be able to attest to your skill, deportment and performance in your chosen profession.   No friends of family nor family members can provide a reference for you.   You will  not be able to return to this page, so please be sure to have this information readily available before you proceed. 


Subsequently, if your application is further shortlisted, we will update you within the next 5-7 business days.    


Please do not share this link. This questionnaire is intended for you where we have seen and considered your credentials. 

Today's / Submission Date:

Name*

Where are you currently resident? *

Nurse or Caregiver (Choose One):*

Select an option

Email Address*

What is your best contact number? *

What is your Whatsapp number? If applicable

NURSES ONLY : Are you a fully registered / licensed Nurse?*

If yes, In what jurisdiction are you registered?

What is your License Number:

In which specific areas of the hospital do you have experience?

What areas of clinical hospital practice do you want to work and / or have greater training?

CAREGIVERS ONLY: Check all that apply.

ALL APPLICANTS: How many years of applicable experience do you have?

Select an option

Are you fully vaccinated?

if applicable, what is your IELTS score? Leave blank if you do not need nor have taken the IELTS exam.

When does your passport expire?*

Which of the following reflects your Visa status?

If you hold a valid visa, when does it expire?

What is your availability? *

When does your current contract end?

Professional Reference #1 Full Name:

Professional Reference #1 Email Address:

Professional Reference #1 Contact No:

Professional Reference #2 Full name:

Professional Reference #2 Email Address:

Professional Reference #2 Contact Number:

Is there anything else that we should know as we consider your application?*

Disclaimer 1 - Please read and accept:

Disclaimer 2 - Please read and accept:

Disclaimer 3 - Please read and accept:

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​Work Permit / Visa Requirements - To Work in Bermuda 

Please go to:  https://www.catalystbermuda.com/wo​rk-in-bermuda for a full list of the requirements to secure a work visa to allow employment in Bermuda. 

Fitness

Bermuda / BOTC Passport Questionnaire 

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Please answer all questions as we prepare your digital BOTC passport application.

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What type of passport are you applying for?*

Please check which applies*

Who is this passport for?*

Surname*

First and middle names*

Maiden or all previous names

Current Address*

Country*

Postcode*

Date of birth*

Gender*

Town of birth*

Country of birth*

Mobile Phone Number*

Alternative Phone Number

Email Address*

Has the person named had any sort of passport (British or Otherwise) or been included in any passport before?*

If yes, please state passport number(s)

Details of lost or stolen passport

Issued at

In year

Holders surname at the time it was issued

First and middle names

How the passport was lost, or why it is not available

Date of loss

Place of loss

Mother's full name*

Town and country of birth*

Date of birth*

Nationality and citizenship at the time of applicant's birth*

If they have a British Overseas Territories passport give the number

Date of issue

Date of issue

Father's full name*

Town and Country of birth*

Date of birth*

Nationality and citizenship at the time of applicant's birth*

If they have a British Overseas Territories passport give the number

Has the applicant been granted a certificate of registration or naturalization?*

If yes, give date of issue, Certificate number and place of issue

Countersignatury's Full Name

Countersignatory's Email address

How long have they known you, and under what capacity?

Countersignatory's employer and the address they work at

Postcode

Mobile Phone number

Alternative phone number

Current Passport number

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