Security Application Form -

For Internal Use Only

VETTING FROM: / /

VETTED BY:

(12/16 weeks from

the above date) / /

SECURITY OFFICER/SAFETY STEWARD

Some description about this section

S.I.A Licence Number

Personal Information

Please provide information regarding your application.

Applicant Information

First Name

Middle Name

Last Name

National Insurance Number

Mobile Number

Address (1)

Address Line 1

Address Line 2

City

Post Code

Less than 5 Years – Provide Previous Address

Address Line 1

Address Line 2

City

Post Code

Car Owner

Driving Licence Number

Bank Details

Please provide you bank details

Name of Bank

Account Number

Name of Account Holder

Sort Code

Personal Details

Please provide further information on your personal situation

Place of Birth

Marital Status

Date of Birth

Current Age

Weight (Kilo’s)

Heights (Cms)

Eyes (Colour)

Emergency Contact Information

Person to be contact in case of emergencies – Next of Kin

First Name

Last Name

Mobile Number

Relationship to Employee

Criminal Offences Information

HAVE YOU EVER APPEARED BEFORE A COURT CHARGED WITH A CRIMINAL, CIVIL OR MILITARY OFFENCE AND BEEN CONVICTED INCLUDING ANY MOTORING OFFENCES HAVE YOU ANY ALLEGED OFFENCES OUTSTANDING.

Yes-No

If Yes – Provide information about the offence/s

References

WHO WE CAN APPROACH FOR A REFERENCE: PLEASE GIVE DETAILS OF TWO PEOPLE, OTHER THAN FAMILY WHO HAVE KNOWN YOU FOR AT LEAST 5 YEARS

First Name

Last Name

Address

Address Line 1

Address Line 2

City

Post Code

Mobile Number

Years Known Applicant

First Name

Last Name

Address

Address Line 1

Address Line 2

City

Post Code

Mobile Number

Years Known Applicant

Personal History

The security screening process requires that we are able to verify your personal history for a period of FIVE years. (If less than 5 years due to school leaving age, please detail form date left till present). Please give details of your personal history, identify in the space provided all periods of EMPLOYMENT self employment, registered or unregistered unemployment (state the unemployment office which you reported to), military service. Be sure to give full addresses including, telephone numbers and dates.

IN THE CASE OF PERIODS OF SELF-EMPLOYMENT PLEASE GIVE NAMES AND ADDRESSES OF SOMEONE WHO CAN CONFIRM YOU’RE DETAILS (ie; BOOK KEEPER, ACCOUNTANT, and OR SOLICITOR).

PLEASE PROVIDE CURRENT EMPLOYMENT STATUS AND WORK BACK FOR 5 YEARS.

Employment History

Section 1

Organisation Name (1)

Employed From?

Employed To?

Address

Address Line 1

Address Line 2

City

Post Code

Line Manager

Job Title

Reason for leaving

Organisation Name (2)

Employed From?

Employed To?

Address

Address Line 1

Address Line 2

City

Post Code

Line Manager

Job Title

Reason for leaving

Employment History

Section 2

Organisation Name (3)

Employed From?

Employed To?

Address

Address Line 1

Address Line 2

City

Post Code

Line Manager

Job Title

Reason for leaving

Organisation Name (4)

Employed From?

Employed To?

Address

Address Line 1

Address Line 2

City

Post Code

Line Manager

Job Title

Reason for leaving

Employment History

Section 3

Organisation Name (5)

Employed From?

Employed To?

Address

Address Line 1

Address Line 2

City

Post Code

Line Manager

Job Title

Reason for leaving

Organisation Name (6)

Employed From?

Employed To?

Address

Address Line 1

Address Line 2

City

Post Code

Line Manager

Job Title

Reason for leaving

Employment History

Section 4

Organisation Name (7)

Employed From?

Employed To?

Address

Address Line 1

Address Line 2

City

Post Code

Line Manager

Job Title

Reason for leaving

Organisation Name (8)

Employed From?

Employed To?

Address

Address Line 1

Address Line 2

City

Post Code

Line Manager

Job Title

Reason for leaving

Personal Financial

Information about your financial situation

HAVE YOU BEEN MADE BANKRUPT

DO YOU OBJECT TO THE COMPANY CONTACTING A CREDIT AGENCY

HAVE YOU ANY COUNTY COURT JUDGEMENTS

Confidential Statement

Education History

Please provide information about your education history.

DETAILS OF WHEN YOU LEFT SCHOOL & IF YOU ATTENDED COLLEGE IN THE LAST 10 YEARS

Secondary Education

Address

Address Line 1

Address Line 2

City

Post Code

Leaving Date

College & Dates

Medical Section

DO YOU SUFFER FROM ANY ILLNESS OR DISABILITY?

IF Please Specify

PLEASE NOTE:

Employees working on night duties may be required to undertake a medical, for further information contact head office

READ THIS SECTION CAREFULLY BEFORE YOU SIGN THE STATEMENT

IF OFFERED EMPLOYMENT IT WILL BE INITIALLY FOR A PROBATIONARY PERIOD OF 16 WEEKS. AFTER A PERIOD OF 12 WEEKS FROM START DATE FOR SCREENING:

DURING THE PROBATIONARY PERIOD YOUR CONTRACT OF EMPLOYMENT MAY BE TERMINABLE BY THE “COMPANY” BY NO LESS THAN 24 HOURS NOTICE IN WRITING. THIS APPLIES TO SCREENING PERIOD ALSO.

CONTINUED EMPLOYMENT IS CONDITIONAL UPON SATISFACTORY SCREENING, MEDICAL AND GENERAL PERFORMANCE.

STATEMENT TO BE SIGNED BY APPLICANT

I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE, THE INFORMATION I

HAVE GIVEN IS COMPLETE AND CORRECT, AN I UNDERSTAND THAT MISREPRESENTATION OF FACTS IS GROUNDS FOR IMMEDIATE DISMISSAL AND RENDERS ME LIABLE FOR PROSECUTION.

I AUTHORISE THE COMPANY TO APPROACH ANY GOVERNMENT AGENCIES, FORMER EMPLOYERS, CREDIT AGENCIES AND PERSONAL REFEREES TO VERIFY THE INFORMATION GIVEN, AND WILL SUPPLY A STATUTORY DECLARATION IF REQUIRED (I GIVE PERMISSION FOR MY PRESENT EMPLOYER TO BE APPROACHED). I CONFIRM IF SUCCESSFUL.

PRINT NAME HERE

Associated Documents Required

N.B. PHOTOCOPIES OF ONE THE DOCUMENTS WILL BE INCLUDED WITHIN VETTING PAPERS.

Have the following documents been provided?

Birth Certificate/Passport

Driving Licence (Both Parts)

S.I.A Licence

Utility Bill/Bank Statement

Service Record

INTERNAL USE ONLY – INTERVIEWER

For internal use only

The following documents have been seen by the interviewer

Birth Certificate/Passport

Driving Licence (Both Parts)

S.I.A Licence

Utility Bill/Bank Statement

Service Record

Interviewer Notes

Section Break

Notes to all Applicants

GTS SOLUTIONS CIC Conforms to the Standard of BS 7858 and as such all applicants must undergo a security screening process.

The application must be completed in full.
A full 5 year work history (or in the case of a younger applicant a 10 year if the company requires the later for client or insurance reasons.
Personal references
Proof of I D
Proof of address
Medical history
National Insurance Check
Criminal Records Bureau Screening via the S.I.A.

As to enable us to process your application please supply the following in full

Full names, addresses and telephone numbers of previous employers
Full names, addresses and telephone numbers of personal references
Full details of any unemployment

Please bring the following items to your interview

Birth certificate
Passport(if held)
Two recent utility bills
Driving licence(if held)
Two passport size photographs
Bank details
P45 if you have one

Failure to complete this application form could result in your application being delayed or rejected. Any information supplied that is found to be fraudulent would result in dismissal or in some cases legal action being taken.

Before proceeding with this application

1 Do you agree to a S.I.A. Criminal record check being carried out?

Do you fully understand the potential consequences?

Do you agree to a credit check taken via a credit agency regards to yourself

I Agree With the Information Provided

PRINT NAME – APPLICANT

Date of Interview