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Title
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First Name
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Surname
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Email Address
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Contact Telephone Number
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National Insurance Number
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Date Of Birth
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House Name / Number
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Street Name
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City
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County
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Postcode
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What is your job occupation?
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Years of experience?
Tickets and Qualifications
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List any cards or tickets
CSCS, CPCS, NPORS, SMSTS etc
References
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Work reference - Company name
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Work reference - Contact name
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Work reference - Contact details
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2nd work reference - Company name
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2nd work reference - Contact name
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2nd work reference - Contact details
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Full name of your emergency contact
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Their relationship to you
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Their contact telephone number
Injury, Illness and Medical Conditions
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Do you have any injury, illness or medical condition(s) that we need to be made aware of?
Yes
No
If yes, please give details below
Eligibility and Criminal Convictions
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Do you have any previous unspent criminal convictions?
Yes
No
If yes, please can you provide details of this and dates?
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Have you ever been subject to a Disclosure and Barring Service (DBS) – formerly called Criminal Records Bureau (CRB)?
Yes
No
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Do you have right to work in the UK?
Yes
No
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Do you hold a current UK driving licence?
Yes
No
Declarations
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I confirm that the information provided in this application and within any Curriculum provided, is both truthful and accurate. I confirm that all facts that have been omitted will not affect my employment. I understand that any false or misleading statement or information could place any subsequent employment in jeopardy. I understand that any offers of work will be subject to documentary evidence of their right to work in the UK, identification and qualifications being provided prior to the start of the contract. I understand that any offers of work will be subject to satisfactory references being taken by Ivy. I consent to personal data contained within this form being recorded for the purposes of assessing suitability for potential offers of work, which may also form the basis of any subsequent work file. I understand and consent to Ivy passing select personal data to prospective or intended employers solely for recruitment purposes? I understand that Ivy will treat any personal information provided in accordance with the requirements of the Data Protection Act 1998, and that these details may be kept on file pending suitable opportunities that arise in the future. I confirm consent to the data contained in my personal file being made available to other relevant organisations for audit and inspection purposes. This includes personal and sensitive data including, without limitation, all documentation/ information related to any criminal record checks. I, the candidate, also agree that I may be required to present a copy of my criminal record check certificate or other related documentation if your file is selected for audit as soon as possible. I understand that I must inform Ivy Resource Group immediately of any changes to the information provided in this document. By submitting this form you agree to all of the above declarations and agree to our terms and privacy policy.
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Password (Password must have at least 10 characters with at least one capital letter, at least one lower case letter, at least one number and one special character E.G !)
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