Applying for clinical attachments with LPT

In this section please give your reasons for applying for a clinical attachment with us.

The information in this form is true and complete. I agree that any deliberate omission, falsification or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal if employed by the organisation. Where applicable, I consent that the organisation can seek clarification regarding professional registration details.

Please state the names and contact details of the people who have agreed to supply references covering a minimum of 3 years employment/training. If you are or have been employed, these should include your two most recent employers, your line manager or someone in a position of responsibility who can comment on your work experience, competence, personal qualities and suitability for the post. Please ensure that you provide full contact details.