Application Form - Regulated Activities printable pdf download

Application Form - Regulated Activities

APPLICATION FORM

POSITION APPLIED FOR:

The following information will be treated in the strictest confidence.

Personal

(Please complete this section in BLOCK CAPITALS)

Surname:

_____________________________________

First name:

_____________________________________

Address:

_____________________________________

Postcode:

_____________________________________

Home telephone number:

_____________________________________

Mobile telephone number:

_____________________________________

Full Driving Licence:

Yes / No Endorsements:

Yes / No

If YES, please give further details including dates:

_______________________________________________________________________________________________

Are you involved in any activity which might limit your availability to work or your working hours

e.g., local government?

Yes / No

If YES, please give full details:

_______________________________________________________________________________________________

Are you subject to any restrictions or covenants which might restrict your working activities?

Yes / No

If YES, please give full details:

_______________________________________________________________________________________________

Are you willing to work overtime and weekends if required?

Yes / No

Please give details of any hours which you would not wish to work:

_______________________________________________________________________________________________

Are you aged over 18?

Yes / No

Page 1 of 6

Application Form - Regulated Activities