Responder Application

Details for the specifications can be accessed below.

Doctor Specification

View

Paramedic Specification

View

If you meet the criteria as laid out in the information above please complete the form below.

Responder Application Form

Personal Information

Full Name & Title(Required)

Address(Required)

Phone(Required)

Email(Required)

Job Title & Employer(Required)

Registered Body(Required)

Registration No.(Required)

Date of Qualification

Renewal Date(Required)

BASICS Membership No.

Renewal Date

Documented Evidence

Has individual BASICS HQ accreditation already been approved?

Yes

BASICS Evidence Upload(Required)

Drop files here or

Accepted file types: jpg, png, doc, pdf, Max. file size: 10 MB.

Please attach copy of application, evidence, and ID badge.

Do you already have a NEAS contract (full / part time / bank / honorary)?

Yes

ID Upload(Required)

Drop files here or

Accepted file types: jpg, png, doc, pdf, Max. file size: 10 MB.

Please upload a copy of ID badge

CV & Cover Letter(Required)

Drop files here or

Accepted file types: pdf, doc, Max. file size: 10 MB.

With reference to the Person Specification as a guide your covering letter should as a minimum include:

Registration details
Details of qualifications
Details of your current role
Details of relevant experience
Why would you like to volunteer as a responder with North East Immediate Care?
If successful, what could you bring to North East Immediate Care?
Which area of the North East are you based and approximately how much time could you commit?
Any other supporting information?

Do you have a current Enhanced DBS Certificate?(Required)

Yes

Enhaced DBS Certificate Upload(Required)

Accepted file types: doc, pdf, jpg, png, Max. file size: 512 MB.

Referee Information

Referee 1 Name(Required)

Referee 1 Position(Required)

Referee 1 Relationship(Required)

Referee Address 1(Required)

Referee 1 Phone(Required)

Referee 1 Email(Required)

Referee 2 Name(Required)

Referee 2 Position(Required)

Referee 2 Relationship(Required)

Referee 2 Address(Required)

Referee 2 Phone(Required)

Referee 2 Email(Required)

Declaration & Submission

Name(Required)

Date(Required)