Application Form

Date Of Application :

PERSONAL DETAILS

Title :

First Name :

Surname :

Date Of Birth :

National Insurance No. :

Example : NX9655377C

Nationality :

British EU Other

If 'Other', please state nationality :

Unspent Criminal Convictions?

Yes No
If 'Yes', please give details :

Do you understand Written & Verbal communication in the English Language?
Yes No

CONTACT DETAILS

House Number/Name :

Street Name :

Town :

City :

County :

PostCode :

Landline Number :

Mobile Number :

Email Address :

I give permission for JE Recruitment to give my mobile number to Clients so that they may contact me during my working day :

Next of Kin :

Tel Number :

DRIVING LICENCE DETAILS

Do you hold a full UK Driving Licence :

Licence Number :

Do you hold a valid DQC Card :

DQC Card Number (found on back of UK DQC card, bottom right hand corner :

Do you have your own transport?

Are you aware of the UK Laws regarding the use of Mobile Phones whilst Driving?

Do you own a Sat Nav for driving Commercial Vehicles?

Do you have any Endorsements on your licence?

If YES give details:

Code on Licence (1) :

Date of Conviction (1) :

Code on Licence (2) :

Date of Conviction (2) :

Code on Licence (3) :

Date of Conviction (3) :

Have you ever been Disqualified from Driving?

If 'YES' give details :

Have you ever had a Driving Accident?

Date of Accident (1) :

Who was at fault? (1) :

Brief Details (1) :

Date of Accident (2) :

Who was at fault? (2) :

Brief Details (2) :

Date of Accident (3) :

Who was at fault? (3) :

Brief Details (3) :

JOB PREFERENCES

Days ?

Nights ?

Nights Out ?

Tramping ?

Trunking ?

Shunting ?

FullTime ?

PartTime ?

Weekends ?

Nights ?

EMPLOYMENT HISTORY

(1) Company Name :

Name of Manager :

Telephone Number :

Your Position :

Start Date :

End Date :

Can we approach for reference ?

(2) Company Name :

Name of Manager :

Telephone Number :

Your Position :

Start Date :

End Date :

Can we approach for reference ?

(3) Company Name :

Name of Manager :

Telephone Number :

Your Position :

Start Date :

End Date :

Can we approach for reference ?

(4) Company Name :

Name of Manager :

Telephone Number :

Your Position :

Start Date :

End Date :

Can we approach for reference ?

DECLARATIONS

I declare that the information I have given in this Application is, to the best of my knowledge, true, accurate and complete. I understand that if it is later discovered that any statement is false or misleading, or that I have withheld relevant information, my application may be disqualified or, if I have already been offered employment, I may be dismissed. I hereby give my consent to JE Recruitment processing the data supplied on this application for the purpose of recruitment and selection.

I confirm that to the best of my knowledge and belief, I have worked in accordance with the requirements of The Road Transport (Working Time) Regulations 2005 throughout the current reference period of my current or most recent employer.

I WILL NOT be engaged in any work outside of my commitment to JE Recruitment which would need to be included in calculations of my working time under The Road Transport (Working Time) Regulations 2005. I agree to inform JE Recruitment immediately if this situation changes and to provide details of hours worked.

I understand that for Health & Safety reasons I must wear PPE (Personal Protective Equipment) at all times to include Safety Footwear, HI-Vis etc

I confirm that I am eligible to work in the UK

I am aware that JE Recruitment is an Equal Opportunities Employer

I have received, read and understood the Terms of Engagement provided by JE Recruitment

I agree that I will correctly declare my earnings in respect of any Benefit Claim

I agree to inform JE Recruitment of any changes in my circumstances which may effect any of my answers given in this application for employment

I understand that a condition of my employment with JE Recruitment requires me to undertake written and verbal instructions from Clients and I confirm I have a good understanding of the English Language both written and verbal

I understand and agree that the details in this application will need to be shared with prospective Companies that JE Recruitment may choose to send me on assignment to

I authorise JE Recruitment to seek references and conduct DVLA checks to assist my application

BANK DETAILS

Bank/Building Society Name :

Building Society Reference Number :

Account in Name of :

Account Number :

SortCode :

Signed by the agency worker (YOU)

Application Form

PERSONAL DETAILS

CONTACT DETAILS

DRIVING LICENCE DETAILS

If YES give details:

JOB PREFERENCES

EXPERIENCE & CERTIFICATION

Certified Skills :

Non-Certified Skills :

Experience :

Area Knowledge :

Commercial Vehicles Driven (please list make of vehicle) :

Gearbox Experience :

EMPLOYMENT HISTORY

MEDICAL QUESTIONNAIRE

DECLARATIONS

BANK DETAILS