CLINICAL RECRUITMENT CV TEMPLATE

POSITION INFORMATION

Passport Photo

Position being applied for:

CANDIDATE PERSONAL DATA (ALL fields are to be DIGITALLY completed)
First Name
Middle Name
Last Name
Mobile: ( )
Phone Number (please make sure to include
your country code and area code) Land-line: ( )

Email Address
Date of Birth (DD/MM/YYYY)
Place of Birth (city & country)
Nationality
Passport(s) Held

Marital Status Single Married Separated Divorced

Relationship Name Age Passport

Dependents

EXPERIENCE DETAILS
Total years of clinical experience
Years of experience in role applied for
FORMAL EDUCATION (start with highest qualification. If accelerated nursing degree, please mention)
Name of College or University
Location of College or University (city &
country)
Graduation Date / /
Duration of Study (MM/YYYY) From: TO:
Major/Course Title (Ex: Bachelors in Nursing)

Study Method Distance Classroom

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 Name of Second College or University
Location of College or University (city &
country)
Graduation Date (DD/MM/YYYY) / /
Duration of Study (MM/YYYY) From: TO:
Major/Course Title
Study Method Distance Classroom
Name of Third College or University
Location of College or University (city &
country)
Graduation Date (DD/MM/YYYY) / /
Duration of Study (MM/YYYY) From: TO:
Major/Course Title
Study Method Distance Classroom
HIGH SCHOOL/SECONDARY SCHOOL
Name of Institution
Location of Institution (city & country)
Graduation Date (DD/MM/YYYY) / /
Is the Institution still in existence and do you
have an original diploma, transcript, or
another source of verification?
CERTIFICATIONS – (EX: BCPS for pharmacist, AACN for Critical Care nurses, etc – don’t include BLS/ACLS here)
Name of Certification
Organization awarding Certification
Dates Certification is Valid (DD/MM/YYYY) / /
Name of Certification
Organization awarding Certification
Dates Certification is Valid (DD/MM/YYYY) / /

LICENSE DETAILS (NURSING/PHARMACY/ALLIED HEALTH)

License 1 2 3

Number

Issue Date / / / / / /

Expiry Date / / / / / /

Issued By
Has your professional license ever been
Yes No Yes No Yes No
suspended or revoked?
Do you have any unresolved disciplinary
Yes No Yes No Yes No
issues in progress? If yes, please specify.
Does the license have any restrictions? If yes,
please specify.

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 Verify if you have the following: Yes No Expiry Date (dd/mm/year)

BLS / /

ACLS / /

PALS / /

HAAD License Exam (by Pearson Vue) / /

NCLEX, and year completed / /

EMPLOYMENT HISTORY – relevant to the job applied

1 2 3 4

Hospital Name

Hospital Location (City, Country)

Hospital Bed Capacity

Type (Primary, Secondary,
Tertiary, Quartrney, Homecare)
Magnet Accreditation Yes No Yes No Yes No Yes No
Joint Commission International
Accreditation (For US Yes No Yes No Yes No Yes No
candidates, JACHO)
Bed Capacity within your Unit

Job Title

Grade/Band
Number of Staff Reporting to
you (FTEs)
/ / / / / / / /
Employment Period, Start to
End Date (DD/MM/YYYY)
/ / / / / / / /

REFERENCE CHECK DETAILS (Supervisor and/or Line Manager)

Please note this will be done only at later stages after obtaining permission from you
Full Name of the Person
Job Title
Contact Email ID
Contact number (Mobile or Landline w Ext)
REFERENCE CHECK DETAILS (Colleague)

Please note this will be done only at later stages after obtaining permission from you
Full Name of the Person
Job Title
Contact Email ID
Contact number (Mobile or Landline w Ext)
I declare and certify that the information given on this CV, and in any documents attached, is correct and complete.

___________________________ / / (DD/MM/YYYY)

Signature Date

Version 3 – April 2017