Do you need a work permit to take up Employment in the U.K.?
If Yes, please give details
Driving Details
Driving Licence Number:
Driving Licence Address:
Address:
Town
County
Postcode
Date Passed Driving Test
Classes of Licence
Expiry Date:
/ /
Expiry Date:
/ /
Expiry Date:
/ /
Expiry Date:
/ /
Expiry Date:
/ /
Have you driven in Europe?
If Yes, please give details
Do you hold a Driver's CPC card?
Valid From:
Valid To:
Do you hold a Digital Tachograph Card?
Valid From:
Valid To:
Have you been involved in any motoring accidents or made any claims or sustained any losses, including theft in connection with any motor vehicle in the last 3 years?
If yes, please give full details:
Have you ever had your licence suspended for any reason?
If Yes, please give full details including breath/alcohol reading in respect of drink driving convictions?
Have you ever been refused motor insurance, had a motor policy cancelled or had special terms imposed?
If Yes, please give full details
Driving Convictions
Please state any driving convictions you have sustained, which are still in force
Offence
Date
Points
Sentence or Fine
Health Details
Have you ever suffered from any serious illness or had any major operation?
If Yes, please give details
Supplementary Information
Do you have any commitments which might limit your working hours?
If Yes, please give details:
Are you willing to work weekends when required?
How much notice are you required to give to leave your present employment?
Previous Employers
Starting with the most recent, please list all the organisations for which you have worked during the last 10 years
Previous Employer 1
Name:
Position Held / Main Duties:
Address:
Town
County
Postcode
Start Date:
Leaving Date:
Start Salary:
Leaving Salary:
Reason for Leaving:
References
Please give the names and addresses of two referees who are not related to you, who we can approach for a confidential assessment of your suitability for this job. (One of these must normally be a previous employer).
Can we approach your present/most recent employer?
Tick this box if you do not wish your employer to be contacted before an offer of employment is made
Reference 1
Name:
Position:
Telephone:
Address:
Town
County
Postcode
Reference 2
Name:
Position:
Telephone:
Address:
Town
County
Postcode
DECLARATION OF APPLICANT
I confirm that the above information is correct.
I understand that any false information or deliberate omissions will disqualify me from employment or may render me liable for dismissal.
I consent to the Organisation processing the information contained herein. I understand that, if successful, the information will be used to form my personnel record and will be retained for the duration of my employment and I consent to the Organisation applying on line every 6 months to confirm my driving licence details are correct and any endorsements are up to date, For this agreement you need to understand that details of your DVLA record and National Insurance number will be shared with other government departments (HMRC and DWP) to check your identity, as described in the DVLA privacy policy https://www.gov.uk/privacypolicy and that you would like the Company to use this service and understand that your data will be shared as explained above.
If I am not successful, I understand that the Organisation will retain the form for a maximum of 6 months, and they may use it to contact me in the event of there being any other vacancies for which I may be suitable.
