Application for employment Please complete in BLOCK CAPITALS and tick boxes where appropriate. PERSONAL DETAILS Ref No: (Office use only) Preferred location: (for driving positions only) Position you are applying: (please tick) PCV driver Trainee driver Other If other please specify Title: (please tick) Mr Mrs Ms Miss First name Surname Email address Address: Postcode: Telephone number Mobile number ELIGIBILITY TO WORK IN THE UK Do you require a work permit to work in the UK? (please tick) Yes No If Yes please provide details: You will be required to provide original documents prior to starting work with the company. Page 1 of 10
DRIVING LICENCE INFORMATION (for driving positions only) Do you hold a driving licence Cat B? Do you hold a PCV Cat D (please choose) Manual Automatic (please choose) Manual Automatic If Yes please provide your PCV expiry date: How many years have you been driving? d d m m y y If you do not hold a full UK driving licence, please state which type of licence you hold Do you hold a Driver s CPC? If Yes please provide your DQ C expiry date: d d m m y y Do you have any endorsements on your driving licence? If Yes, how many current penalty points are on your licence Please provide details Have you been disqualified from driving in the last five years? If Yes, please provide details PROFESSIONAL QUALIFICATIONS (for driving positions only) Do you hold a BTEC qualification in Operating a bus service in London? Yes No Please provide copies of the following if applicable: DQC BTEC NVQ Certificate CPC Certificate(s) Page 2 of 10
Page 3 of 10 INCIDENTS (for driving positions only) Please give details of all motor accidents you have had in the last 5 years (including accidents which have occurred in a bus) EMPLOYMENT HISTORY Please complete details covering the last ten years of employment starting with the most current or last employer including the Bus/Transport Industry. Please explain any periods of unemployed or gaps in employment if applicable Company name Company name Address Address Postcode Postcode Dates of employment: Dates of employment: Job Title Job Title Reason for leaving Reason for leaving Responsibilities/duties Responsibilities/duties
EMPLOYMENT HISTORY (continued) Company name Company name Address Address Postcode Postcode Dates of employment: Dates of employment: Job Title Job Title Reason for leaving Reason for leaving Responsibilities/duties Responsibilities/duties Please feel free to continue on a separate piece of paper if necessary Have you ever been dismissed from your previous employment? Yes No If Yes please provide details Page 4 of 10
EDUCATION DETAILS Name of School / College / University Name of School / College / University Dates Dates Course Title Course Title Qualification gained Qualification gained Name of School / College / University Name of School / College / University Dates Dates Course Title Course Title Qualification gained Qualification gained Please feel free to continue on a separate piece of paper if necessary Page 5 of 10
REFERENCES DETAILS Please provide full details of two referees, they should be your most current or last employer(s). Company name: Company name: Contact name: Contact name: Telephone Telephone Email Email At this stage do we have your permission to contact your referee At this stage do we have your permission to contact your referee Page 6 of 10
PERSONAL STATEMENT Our Aims To provide the best possible service to our Customers To provide our staff with secure, rewarding employment To be successful, profitable company with a long term future Please use the space below to explain how our aims, your skills and attributes match those on the job description. Include any further information to support your application for employment with our Company. Please feel free to continue on a separate piece of paper Please give the date you would be available to start employment in the event of your application being successful Please provide details of any holiday dates that are confirmed Whilst we will try to ensure that we accommodate any dates already confirmed, they are also subjective to Local Management authorisation Page 7 of 10
Page 8 of 10 Your application Have you previously applied to Abellio; (including National Express, Travel London, Connex, Limebourne) Yes No If Yes, please provide details, including dates Please provide details how you heard about this vacancy Please tick box Please state which one, if applicable Newspaper Radio Station Job Centre Abellio Website Internet Search Friend Other (please specify)
EQUAL OPPORTUNITIES MONITORING INFORMATION This sheet will be separated from your application form upon receipt and does not form part of the selection process. It will be retained by the Human Resources purely for monitoring purposes. Ethnic origin Please tick the following boxes as appropriate. 1. WHITE 3. ASIAN 5. CHINESE 2. MIXED RACE 4. BLACK 6. OTHER Sex 1. MALE 2. FEMALE Disability Do you consider yourself to have a disability? Yes No What is the effect or impact of your disability or health condition?... Prefer not to say If you have a disability please tell us about any adjustments we may need to make to assist you at interview CONVICTIONS Ex-offenders will be considered for employment on their merit. Convictions are only taken into account if they are related to the post applied for. Please enter details of any court or court martial conviction giving all relevant details. If you have no convictions then write NONE. The Rehabilitation of Offenders Act, 1974. You need not enter details of any offence which is spent under the terms of the Act. If you are uncertain whether or not your offences are spent, contact your local Citizens Advice Bureau for confidential advice. Any false statement or declaration will disqualify you from employment or, if discovered after employment has commenced, will render you liable for instant dismissal. Page 9 of 10
Page 10 of 10 CANDIDATE DECLARATION I confirm that the information provided in this application and any additional documentation is both truthful and accurate. I have omitted no facts that could affect my employment. I understand that any false misleading statements could place any subsequent employment in jeopardy and may lead to my dismissal. I understand that any employment entered into is subject to documentary evidence of my right to work in the UK and satisfactory references. I expressly consent to personal data contained within this form under the Data Protection Act 1998 being recorded for the purposes of assessing suitability for the post and may form the basis of any subsequent personnel file. Print name Signed Date The company retains the right to reject any application without assigning a reason. No appointment will be confirmed until references (which will not be taken up without the applicant s prior knowledge and consent) have been received. If they do not reach the standards we require, or if the applicant does not satisfy the medical standards of the company any previous offer of employment may be withdrawn.