Introduction

National insurance number * Candidate name

Personal Details

Title

Forename(s) *

Surname *

Do you have a previous surname? * -- please select -- Yes, I do have a previous surname No, I do not National insurance number * S.I.A License number * S.I.A License expiry *

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Current address * ZIP/Postode * Have you lived at this address for more than 3 years? * -- please select -- Yes, I have No, I have not

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Home phone no Work phone no Mobile phone no * E-mail address *

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Date of birth *

Age *

Birth place * Nationality *

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Are you subject to immigration control? * * -- please select -- Yes, I am No, I am not

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Height *	Weight *	Eye colour *	Hair colour *

Any distinguishing marks or scars?

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Marital status * -- Please select -- Married With partner Single Divorced Separated

Next of kin *

Relationship to next of kin *

Next of kin contact number *

Dependants by age

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Do you hold a current full UK driving license? * -- please select -- No, I do not Yes, I do

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Do you own a car or motorcycle? * -- please select -- No, I do not Yes, a car Yes, a motorcycle Do you hold a current C.S.C.S card? * -- please select -- No, I do not Yes, I do

Have you ever been cautioned by the police? * -- please select -- Yes No Have you ever been prosecuted for a criminal offence or are there any prosecutions pending? * -- please select -- Yes No Have you ever been prosecuted for a motoring offence or are there any prosecutions pending? * -- please select -- Yes No Have you ever been a party to an action in any court or tribunal? * -- please select -- Yes No Have you ever been declared bankrupt or made a deed by arrangement? * -- please select -- Yes No Have any orders been made against you by a Civil or military Court or Public Authority? * -- please select -- Yes No

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Add new record Remove Last Record

Have you been in the Armed/Police service? * -- please select -- No, I have not Yes, I have

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Add new record Remove Last Record

Referee 1 Referee 1 - Name * Profession * How long known? * Years Address * Contact Tel No. * Please include country code if outside of UK Email *

Referee 2 Referee 2 - Name * Profession * How long known? * Years Address * Contact Tel No. * Please include country code if outside of UK Email *

Screening & vetting

I certify that to the best of my knowledge, the information that I have given by me in this application is true and complete to the best of my knowledge and belief. I understand that any false statement or omission may render me liable to prosecution or dismissal without notice. I fully understand the consequences which may arise as a result of knowingly making a false declaration to gain employment or pecuniary advantage. (Theft Act 1968 Section 16). I accept that I may be required to undergo a medical examination where requested by the Company and I consent to the results of such examination being given to a Company Director. I further understand that a credit agency check may be carried out on me and I give my consent to this. I understand and agree that if so required I will make a Statutory Declaration in accordance with the provisions of the Statutory Declarations Act 1835, in confirmation of previous employment or unemployment. I authorize the company to approach Government agencies, former employers and personal referees for verification of my employment/unemployment record.

Disclosure

You may be employed in a position of trust by a company or one of its subsidiary companies we may have to apply for a Disclosure from the Criminal Records Bureaux. However, having a criminal record does not necessarily bar you from employment. If you wish to obtain more information please ask The Company Personnel Department for their Code of Practice or their policy statement regarding ex-offenders. Disclosure information is treated in a sensitive way and is restricted to those who need to see it to make a recruitment decision. The Disclosure information is not retained i.e. it is disposed of within the timescales; recommended in the CRB Code of Practice. By signing below you agree to this process.

Data Protection Act 1998

We will use the information you have given on this form (together with any information which we obtain with your consent from third parties) for assessing your suitability for employment within certain contracts managed by your employers. It may be necessary to disclose your information to our agents and other service providers.

By returning this form to us you consent to our processing sensitive personal data about you where this is necessary, for example information about your past employment, finances, ethnic origin or criminal offences. You also consent to the transfer of your information to your employers where this is necessary. Your information will be held on our computer database and in our paper filing systems. You have the right to apply for a copy of your information (for which we may charge a small fee) and to have any inaccuracies corrected.