appendix 2

This form must be completed in full in order for a candidate to be eligible for further consideration

Immigration Status

NAME: / Post Ref No:
POST APPLIED FOR:
  1. Are you a British Citizen or EEC National?

  1. Did you obtain your primary medical qualification in the UK/EEC?
/ YES / NO

If you have answered ‘NO’ to either question please continue

  1. On what date did you enter the UK?
/ Day: / Month: / Year:
  1. Have you worked in the UK before?
/ YES / NO
If ‘NO’, have you achieved a minimum score of 7 in each of the four sections of the IELTS
(International English Language Testing System administered by The British Council) / YES / NO
If ‘NO’ please give details

There are no exemptions to the IELTS

  1. Have you successfully passed the PLAB Test?
/ YES / NO
If ‘NO’ are you exempt and on what basis?
  1. Do you have evidence of entitlement to enter and work in the UK for an unlimited period?
/ YES / NO
  1. If you answered ‘YES’ to question 6, please tick one of the following:

a) / Settled Status
b) / Spouse of British Citizen / Please state visa expiry date:
c) / Commonwealth grand-citizen with grandparents born in the UK
d) / Refugee / Please state visa expiry date:
  1. If you answered ‘NO’ to question 6, what is your current immigration status and please state the expiry date:

a)HSMP (Highly Skilled Migrant Programme) / Please state visa expiry date:
b)Tier 1 / Tier 1 dependant (with no restrictions) / Please state visa expiry date:
c)Tier 1 / Tier 1 dependant (with restrictions,
no employment as doctor in training) / Please state visa expiry date:
d)Work Permit / Please state visa expiry date:
e)Tier 2 (Sponsor Certificate) / Please state visa expiry date:
f)Post graduate doctor / dentist / Please state visa expiry date:
g)Student / Please state visa expiry date:
h)Clinical attachment / dental observer posts / Please state visa expiry date:
i)Any other (i.e. TWES, IGS, SE, GS, MTI) / Please state visa expiry date:
Please state the relevant category:

PLEASE SEND DOCUMENTARY EVIDENCE IN CONNECTION WITH QUESTIONS 4 TO 8, E.G. PHOTOCOPIES OF PASSPORT, VISA, LETTER OF IMMIGRATION STATUS FROM THE HOME OFFICE, ETC.

FOR FURTHER INFORMATION SEE GUIDANCE AT

Note: If you are called for interview, you will be asked to provide original documentary evidence of entitlement to enter and work in the United Kingdom.