<p>TEMPORARY WORKER – APPLICATION FORM</p><p>DRIVING INDUSTRIAL SECURITY DOMESTIC </p><p>Surname First Name Last Name</p><p>Date of Birth National Insurance No: Nationality</p><p>Address Do you have a full driving license? Passport photo</p><p>YES NO </p><p>Number of Points on License Reason for Points ------</p><p>Have you got your own car or access to a car?</p><p>Post code: Telephone: Mobile no:</p><p>When are you available to start: Any preferred Location for work: Minimum pay rate: Do you have any pending criminal charges? How did you know bout Classic Recruitment: YES NO Are you Disable: If yes give details:</p><p>Mark to show areas of experience where certification is required, you will be asked for relevant documents</p><p>Vehicle Type Operations Equipment Warehouse Security 3.5 Tonne Driver Stock taking Order Packing Refuse Loader 7.5 Tonne Driver Multi - drop Counter Balance Certification Production Operative Trailer: Draw Bar Narrow Reach Certification Order Picking Car Delivery Trunking Goods In/Out Cleaning Tipper Airports Fork Lift Certification Drivers Mate Tankers Supermarkets Refrigeration Labouring PSC single/double International Skips Ground Maintenance ADR Shunting Lorry Mounting Litter Picker HIAB Night out Chain Toggle Street Cleaner Where have you driving skills been practically assessed? Company: Date:</p><p>Do you consider fit to carry out Light work Medium work Heavy Work What safety equipment do you own? Safety Boots Helmet Gloves High visibility Jacket</p><p> lease mark to indicate your times and days availability Time Monday Tuesday Wednesday Thursday Friday Saturday Sunday</p><p>Day</p><p>Night</p><p>Split</p><p>Give dates you are available for work References / Previous Employment / Professional Bodies</p><p>Name:</p><p>Position: Address:</p><p>Phone No:</p><p>How do you know this person?</p><p>Name:</p><p>Position: Address</p><p>Phone Number:</p><p>How do you know this person?</p><p>BANK DETAILS Sort Code: Bank/building society Account Number: Bank Address: Ref/Roll Number:</p><p>Name of Account Holder:</p><p>Rehabilitation of Offenders Act (1974)</p><p>Do you have any convictions that are unspent under the rehabilitation of offenders act 1974 YES NO </p><p>If yes, please give details/ dates of offence (s) and sentences:</p><p>PERSONAL DECLARATION</p><p>I confirm that the information I have given is correct and I have not with held any information of which the company should be made aware. I also understand that giving any incorrect or misleading information could lead to mu subsequent dismissal or withdrawal/termination of assignment.</p><p>I authorize Classic Recruitment Ltd to use the personal information I have given on this application from to obtain references and also supply any of this information to a prospective employer.</p><p>Signature of Applicant______Date ______EDUCATION</p><p>Date Name of institution and Address Qualification/Examinations Grades Obtained</p><p>Any other relevant qualification to the job you are applying for (please include name of institution and result of all)</p><p>CURENT/PREVIOUS EMPLOYMENT – Please start with your current or most recent employers first (cover the last 5 years)</p><p>From To NAME & ADDRESS OF COMPANY JOB TITLE &DETAILS SALARY REASON FOR LEAVING</p><p>Please send back or email the completed form to</p><p>2 Ground floor, Woodberry Grove London, N12 ODR, United Kingdom Tel No: 01753534359</p><p>Email: [email protected] Fax: +44(0) 175357861</p>