V2F Support Services Application Form

Applicant Information
Date:*
Full Name:*
Street Address:*
Apartment:
City:*
Country:*
Post Code:
Phone:* Email*
Date Available: Date of Birth*:
Position Applied for: *
Are you a citizen of the United Kingdom? YES NO If no, do you have permit to work in the U.K.? YES NO
Have you ever worked for this company?YES NO If yes, when?
Have you ever been convicted of a Crime?YES NO If yes, explain:
Education
High School: Address:
From: To: Did you graduate?YES NO Diploma
College: Address:
From: To: Did you graduate?YES NO Degree
Other: Address:
From: To: Did you graduate?YES NO Degree
References - Please list two professional references.
Professional Reference (1)*
Employment
Company Phone:
Address: Supervisor:
Job Title: Responsibilities:
From: To: Reason for Leaving:
May we contact your previous supervisor for a reference?YES NO  
Have any Disability: YES NO Ethnic Origin:
Driving License:YES NO Do you have DBS:YES NO
Next of Kin contact details:  
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature:* Date: *
Please study this list and sign the declaration at the bottom
Do you have Diabetes needing Insulin? YES NO
Have you ever had blackouts, recurrent dizziness or any condition, which may cause sudden collapse or incapacity? YES NO
Do you get discomfort or pain in the chest or shortness of breath on exercise, e.g. climbing a single flight of stairs? YES NO
Do you have difficulty in moving rapidly over short distances, including on slopes, steps or rough ground? YES NO
Would you have difficulty in looking over either shoulder? YES NO
Would you have difficulty working in out-door open areas? YES NO
Would you have difficulty working in enclosed spaces? YES NO
Would you have difficulty working above head height (e.g. using ladders or maintenance platforms)? YES NO
Do you have difficulty with your eyesight? YES NO
If yes, do you wear spectacles/ contact lenses? YES NO
Do you have difficulty in correctly identifying colours? YES NO
Do you have any difficulty with your hearing? YES NO
Are you taking any medication that is giving you dizziness or drowsiness? YES NO
Have you used, or abused, drugs within the last 12 months? YES NO
Have you had any alcohol-related illness during the last 12 months? YES NO
GDPR REGULATIONS 2018
Regulations have now changed in which we now need you to advise us of the best methods of contact. We now require you to confirm the best method of contact. Please can you confirm by ticking the appropriate boxes below: Email SMS Telephone
Our Clients require that we send them a copy of your CV for review before and whilst working on their assignments do you provide your consent in doing so? YES NO
At V2F Ltd we follow a working procedure that requires us to send a weekly roster to all clients and staff. The roster is a spreadsheet that contains staff email addresses, contact telephone number and home postcodes. The reason we share this information is in order to ensure the smooth running of the weekly working schedules. Do you consent to this information being sent to the parties concerned? YES NO
Competencies
Please check all Competencies that you hold

MANUAL HANDLING FIRST AID CSCS SIA PTS Health Care Certification OTHER (Please indicate below)
Other Competencies
Required Documents
CV*
Copy of passport or birth certificate or Residence Permit card or Biometric Residence Card. *
Proof of National Insurance (P45, P60, letter from tax or payslip from previous company)
Drivers licence including counterpart or any other .
Copies of any certification/competence related to your role within V2f Ltd
Proof of address *
Qualification 1 *
Qualification 2
Qualification 3
DBS certificate
Declaration
Print Name in Full (This will be taken as your digital signature and acceptance of the above declaration)*
Consent*
I have completed this form by myself YES NO
* field is mandatory