National Performers Lists Application Form Page 7
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3215. Please indicate in what capacity you wish to join the performers list
Medical list
Dental list
Opthalmic list
GP performer
Dental performer
Ophthalmic performer
Salaried GP by practice
Foundation dentist
Ophthalmic medical
practitioner
Salaried GP by CCG
Dentist undertaking
foundation training by
assessment
GP registrar
GP locum
GP returner scheme
GP retainer scheme
Armed services Type 1
Armed services Type 2
16. Nationality
16.1. Please state your country of birth
Yes
No
16.2. Are you a full British Citizen or an EEA
National?
If Yes go to section 2, question 17
Yes
No
16.3. Do you have evidence of entitlement to
enter and work in the United Kingdom (e.g.,
settled status, spouse of a British Citizen?) If
No go to next question.
Yes
No
16.4. Were you admitted to the UK as a doctor
or dentist before 1 April 1985? If No go to
next question.
What is your immigration status? – please tick 16.4(a) or 16.4(b) as appropriate:
NPL1 Application Form v2 final
Page 7 of 32
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