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Screening Permission

To carry out a financial check and / or a check of criminal records outside of the UK we need your permission
and the completion of this Data Subject Consent form. The information you are about to provide on this
form is personal to you and Agenda Screening Services recognises how important this information is. We
ensure the integrity and confidentiality of your information by a number of methods including conducting the
screening in Secured by Design premises under ISO27001 Information Security Management System
processes and by comprehensively screened staff. Your information will not be disclosed to any 3rd party other
than the client and it will be permanently destroyed within one year after the completion of the screening.

Please complete the form fully

Title (Mr/Mrs/Dr etc) Date of Birth

First Name(s) Surname
Previous Name(s) Place of Birth
Mobile Phone No.
Home Phone No.
E-mail Address

Current Address...............................................................................................................................................

..........................................................................................................................................................................

Post Code .......................................................Lived here since (Month/Year)................................................

Agenda is registered under the conditions of the General Data Protection Regulation (GDPR) with the
Information Commissioners’ Office and by providing your personal details to us we will ensure that we process
your data in compliance with GDPR. In addition to checking the validity of the information that you have
provided we will use Open Source and Internet based checks. If you would like any further information please
contact us directly through agendascreening@agenda-screening.co.uk or visit https://www.agenda-
screening.co.uk/pre-employment-screening-privacy-notice

Pre-employment Screening Permission and Material Facts Statement: I agree that Agenda and
its agents can carry out pre-employment checks on behalf of the client and that all information supplied by
me in this application process is genuine, accurate, relevant and up to date, I also confirm that I also consent
to my personal details being sent outside the EU when necessary to complete this screening process.

Signed…………………………………………………….....Dated…………………………………….

1 | Page May 2018

Version 1.5