NOTE  :  *  Fields are required.
Title:*
Surname:*
Forenames
Maiden/Former Name (List all previous first names and surnames)
Date of Birth:
National Insurance No:
Nationality:*
Mobile No:*
Email address:*
Please list all previous places of residence during the past 6 years
From To Address
Do You Hold A Current Sia Licence* YesNo
Type:
Expiry Date:
SIA NO:
 
Date of entry to UK (if applicable):
Are you subject to immigration control?* YesNo
If yes, do you have an unrestricted entitlement to take up employment in the UK?* YesNo
(Please note if you have been in this country for less than 5 years or have been out of the country for a period of 6 months or longer during the last 5 years it is your responsibility to provide a criminal check certificate from your previous country of residence. Your application will not be considered without this certificate)
 
Please list visits abroad that were for 31 days or longer (passport will be inspected)
From

Month/Year
To

Month/Year
Country
 
Do you hold a full driving license* YesNo
Provisional* YesNo
Is your license free of any endorsements* YesNo
If no, how many points are currently in force
Do you have any motoring offences or cautions, include any that are pending*: YesNo
If yes please give details
Do you own or have use of transport if so, what
Please sign
 
Have you ever been declared bankrupt?* YesNo
If yes please give details
Please sign
 
Do you have any outstanding County Court Judgments(CCJ)?* YesNo
If yes please give details
Please sign
 
Has any order been made against you by a Civil or Military Court or Public Authority ?* YesNo
If yes please give details
Please sign
 
Criminal Disclosure & Rehabilitation of Offenders Act Exceptions Order 2001

The post you are applying for requires a Criminal Record Check (Disclosure) prior to appointment, you are required to declare 'unspent' convictions and will be questioned on this at interview.

In accordance with the Rehabilitation of Offenders Act 1974 only relevant convictions will be taken into account when assessing your suitability.
 
Give details including dates, of any sentence or order alleged or otherwise made by any court, criminal, civic or military, or answer none:
Please sign
 
Please note all personal data will be used for the purpose of personal screening and any documents presented will be checked using methods to deter identity theft and fraud. Any original documents that appear to be a forgery will be reported to the relevant authorities
 
Education References
Secondary Schools attended from age of 16
Dates

(From-To)
Name and address of school (s) Qualifications obtained
*
*
*

Other Training or Courses
Dates

(From-To)
Name of Organizing Body Subjects studied Qualifications obtained
 
Employment and unemployment history
Are you working at present* YesNo

Starting with your last or present employer, give details of your employment history for the last 5 years, including details of full time education if it falls within that period. Include periods of self employment and military service. For any periods of unemployment give the address of the DWP office to which you reported or the name of a person (not a relative) who can confirm your whereabouts.
Please state if we may contact your present employer* YesNo
 
If no please give details of a personal referee and/or documents which confirm your employment
Name and full address of current employer or name of Job Centre/DWP Office Details Unemployment/employment dates
Name:

Position held:

From:

Address:

Reporting to:

To:

Tel:

Email:

Reason for leaving

 
Name and full address of current employer or name of Job Centre/DWP Office Details Unemployment/employment dates
Name:

Position held:

From:

Address:

Reporting to:

To:

Tel:

Email:

Reason for leaving

 
Name and full address of current employer or name of Job Centre/DWP Office Details Unemployment/employment dates
Name:

Position held:

From:

Address:

Reporting to:

To:

Tel:

Email:

Reason for leaving

 
Name and full address of current employer or name of Job Centre/DWP Office Details Unemployment/employment dates
Name:

Position held:

From:

Address:

Reporting to:

To:

Tel:

Email:

Reason for leaving

 
Please list hours you are available for work
  Hrs available - day Hrs available - night
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
 
Please give your reasons for applying and any other information you consider relevant including what you believe you can contribute to the job, interests or other information which you wish to be taken into consideration
 
Do you have any holidays booked within the next 6 months if yes, please state dates.
 
Why should we employ you?
 
What skills can you bring to this position?
 
Please note applications will not be considered if they are incomplete.
Please read this carefully before signing this application form

Declarations

I understand that employment with this company is subject to references and screening in accordance with BS 7858.

I confirm that the information I have provided on my application is true and complete to the best of my knowledge. I understand and agree that I will be subject to any or all of the following checks:

  • Address check
  • Financial probity check which the company will retain on file
  • ID verification checks
  • Academic/professional qualification check
  • Employment history, including any period of unemployment/Self-employment and any gaps
  • Criminal background check

I authorise the company or its agents to approach government agencies, former employers, educational establishments, for information relating to and verification of my employment or unemployment history, a consumer information search and ID check with a credit reference agency, which will keep a record of those searches in line with current legislation.

I further declare that any documents that I provide as proof of my identity, proof of address, and any other documents that I provide are genuine and that any falsified documents may be reported to the appropriate authority. I understand that it may be a criminal offence to attempt to obtain employment by deception and that any misrepresentation, omission of a material fact or deception will be cause for immediate withdrawal of any offer of employment.

I accept that I may be required to undergo a medical examination where requested by the company. I understand and agree that if so required I will make a statutory declaration in accordance with the provisions of the Statutory Declaration Act 1835, in confirmation of previous employment or unemployment.

By signing this declaration, I agree that I have provided complete and true information in support of the application and that I understand that knowingly making a false statement for this purpose is a criminal offence.

Please sign to confirm you agree to the above processing terms:

Print Name
Applicant Signature
Date
CRIMINAL BACKGROUND CHECK

You are applying for a position of trust and in the event of being offered employment by the company we may apply for a criminal background check. However, having a criminal record does not necessarily bar you from employment. For more information ask a member of staff for a copy of the appropriate criminal record body code of practice and / or our company policy statement regarding ex-offenders. Criminal record information is treated in a sensitive way and is restricted to those who need to see it to make a recruitment decision. By signing this document, upon request you agree to provide a copy of the criminal record certificates. The criminal background information is not retained. By signing below you agree to this process.

Screening

The applicant consents to being screening in accordance with BS7858 and will provide information as required. Any offer of employment is subject to satisfactory screening and the applicant acknowledges that any false statements or omissions could lead to termination of employment.

Applicant Name
Applicant Signature
NI Number
Date