JY DOOR

SECURITY
Tel: 07821204082
JY DOOR SECURITY
Application For
Please complete this form fully using black or blue ink and BLOCK CAPITALS
T!E I"FOR#ATIO" YOU SU$$%Y O" T!IS FOR# &I%% 'E TREATED I" CO"FIDE"CE(
Section 1 $er)onal *etail)
Last
Name:
First Name:
A**re)):
Postcode:
Date of
Birth:
%etter) "+,er) %etter
!oe Telep-one "
o
: "ational In)+rance "
o
:
Da.tie Telep-one "
o
:

#o,ile Telep-one "
o
:
E/ail a**re)):
Are .o+ 0ree to reain an* ta1e +p eplo.ent in
t-e U2 3it- no c+rrent ii4ration re)triction)5
Ye) "o
Dri6in4 %icen)e
Do you hold a full, clean driving license valid in the UK
Ye) "o
Do you have a SIA 7Sec+rit. In*+)tr. A+t-orit.8 licence
If .e) !lease list the licence"s# you hold$
Post Applied
for:
Ye) "o
%lease !ut your licence n+,er) in the &o' &elo($ E9pire Date
Section 2 $re)ent Eplo.ent
$re)ent Eplo.ent "If no( une)!loyed give details of last e)!loyer#
"ae o0 Eplo.er:
A**re)):
Postcode:
$o)t Title:
Date o0 Appointent: Salary:
Departent : Section:
'rie0 *e)cription o0 *+tie):
$erio* o0 "otice:
%a)t *a. o0 )er6ice
"if no longer e)!loyed#:
Rea)on 0or lea6in4
"if no longer e)!loyed#:
Section ; Recr+itent #onitorin4 For
<en*er
#ale Feale
&-at i) .o+r Et-nic <ro+p5
Choose O*E section fro) + to E, and then tic, the a!!ro!riate &o' to indicate your cultural &ac,ground$
A. White D( 'lac1 or 'lac1 'riti)-
-hite UK
.lac, Cari&&ean
Irish .lac, +frican
White non-UK Any other Black background
"!lease give details#/
Any other White background
(please give details):
'( #i9e*
E( C-ine)e or ot-er et-nic 4ro+p
White & Black aribbean
Chinese
White & Black A!rican
0ietna)ese
White & Asian
Any other ethnic background
"!lease give details#/
Any other "i#ed background
(please give details):
C( A)ian or A)ian 'riti)- F( I *o not 3i)- to pro6i*e t-i)
in0oration
Indian
$akistani
Bangladeshi
Any other Asian background
(please give details):
Section 7 Re-a,ilitation o0 O00en*er) Act 71=748
Do .o+ -a6e an. con6iction) t-at are +n)pent +n*er t-e
re-a,ilitation o0 o00en*er>) act 1=745
Ye) "o
I0 .e)? plea)e 4i6e *etail) : *ate) o0 o00ence7)8 an* )entence:
Section 8 $rotectin4 C-il*ren an* @+lnera,le A*+lt)
The follo(ing infor)ation )ay &e re1uired if the !ost you are a!!lying for has a re1uire)ent for a Cri)inal
Records .ureau !olice chec,$
En-ance* C-ec1) Onl.(
Are .o+ a3are o0 an. police enA+ire) +n*erta1en 0ollo3in4
alle4ation) a*e a4ain)t .o+? 3-ic- a. -a6e a ,earin4 on .o+r
)+ita,ilit. 0or t-i) po)t5
Ye) "o
Section = Disability and Equality Act 2010
This +ct !rotects !eo!le (ith disa&ilities fro) unla(ful discri)ination$ -e actively encourage a!!lications fro)
!eo!le (ith disa&ilities$ The Disa&ility and the E1uality act 2343 defines a disa&led !erson as so)eone (ho
has a !hysical or )ental i)!air)ent (hich has a su&stantial and adverse long ter) effect on his or her a&ility to
carry out nor)al day to day activities$
Do .o+ con)i*er .o+r)el0 to -a6e a *i)a,ilit.5 Ye) "o
I0 .e)? plea)e 4i6e *etail):
Section 10 !ealt-
!o3 an. )ic1 *a.) -a6e .o+ ta1en in t-e la)t .ear:
$lea)e )tate n+,er o0 occa)ion) in t-e la)t .ear:
Section 11 Re0erence)
%lease give the na)es and addresses of your t(o )ost recent e)!loyers "if a!!lica&le#$ If you are una&le to do
this, !lease clearly outline (ho your references are$
Re0erence 1 Re0erence 2
Name: Name:
$o)ition 7Bo,
title8:
$o)ition 7Bo,
title8:
&or1
Relation)-ip:
&or1
Relation)-ip:
Or4ani)ation: Or4ani)ation:
A**re)): A**re)):
$o)tco*e $o)tco*e
Telep-one "
o
: Telep-one "
o
:
E-mail: E/ail:
+re you (illing for this
referee to &e a!!roached
Ye) "o
+re you (illing for this
referee to &e a!!roached
Ye) "o
Section 12 Eer4enc. Contact Detail)
$lea)e pro6i*e contact *etail) o0 t3o people 3e a. contact in t-e ca)e o0 an eer4enc.
"ae o0 contact:
Relation)-ip:
A**re)):
Postcode:
#o,ile n+,er:
!oe "+,er:
&or1 "+,er:
"ae o0 contact:
Relation)-ip:
A**re)):
Postcode:
#o,ile n+,er:
!oe "+,er:
&or1 "+,er:
Doctor) nae:
A**re)):
Section 1C $er)onal 'an1 Detail)
In0oration pro6i*e* on t-i) 0or i) co6ere* ,. t-e *ata protection act(
"ae on acco+nt:
'an1:
'an1 A**re)):
Postcode:

Sort Co*e :

Acco+nt "+,er:
Section 14 Declaration
Stateent to ,e Si4ne* ,. t-e Applicant
%lease co)!lete the follo(ing declaration and sign it in the a!!ro!riate !lace &elo($ If this declaration
is not co)!leted and signed, your a!!lication (ill not &e considered$
I -ere,. certi0. t-at:
all t-e in0oration 4i6en ,. e on t-i) 0or i) correct to t-e ,e)t o0 . 1no3le*4e
all A+e)tion) relatin4 to e -a6e ,een acc+ratel. an* 0+ll. an)3ere*
I po))e)) all t-e A+ali0ication) 3-ic- I clai to -ol*
I -a6e rea* an*? i0 appointe*? a prepare* to accept t-e con*ition) )et o+t in t-e
con*ition) o0 eplo.ent an* t-e Bo, *e)cription(
Signed: Date:
"Candidates selected for intervie( (ill nor)ally &e notified (ithin three (ee,s$ Than, you for your interest in
this !ost$ If you (ould li,e to ,no( if (e have received your a!!lication for) !lease do not hesitate to call us$#
JY DOOR SECURITY +n*erta1e) t-at it 3ill treat an. per)onal in0oration 7t-at i) *ata 0ro
3-ic- .o+ can ,e i*enti0ie*? )+c- a) .o+r nae? a**re))? e/ail a**re)) etc8 t-at .o+ pro6i*e
to +)? or t-at 3e o,tain 0ro .o+? in accor*ance 3it- t-e reA+ireent) o0 t-e Data $rotection
Act 1==8(
R E T U R " I " < T ! I S F O R #
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