PLEASE RETURN THE COMPLETED Vigilant Security Services AMC Business House 12 Cumberland London NW107QL ~NYONE ELSE IS

SECOND BEST!

FORM TO:

UK Limited

Avenue

Tel: 0207 1834247 Fax: 0208 961 3905

APPLICA nON FORM

CONFIDENTIAL (WHEN COMPLETE)

FOR DATA PROTECTION PURPOSES, THIS APPLICATION FORM WILL BE SHREDDED AFTER ONE YEAR, IF YOUR APPLICATION WAS UNSUSSESSFUL
CONFIDENTIAL (WHEN COMPLETE)
NOTES: 1. PLEASE USE BLACK INK AND CAPITAL LETTERS 2. PLEASE ANSWER ALL QUESTIONS
(USE N/A, NO OR NONE IF A QUESTION DOES NOT APPLY)

3. PLEASE READ ALL SECTIONS CAREFULLY AND SIGN WHERE APPLICABLE (Now Please Turn Over)

-- FOR OFFICE USE ONL Y

INAME I lID ISTART DATE IISCREENING DATE

- ---- ----

- _.
I

-- --

I
NOTES

I PROBATION DATE I

PHOTO

ISIA LICENCE NO.

IISIA

EXPIRY DATE I

I LICENCE TYPE

IITRAINING

DOCUMENTS SEEN
PASSPORT PROOF OF ADDRESS

0 0

PASSPORT/VISA TYPE EXP.

I
0

SIA LICENCE

DRIVING LICENCE

UK BIRTH CERTIFICATE

0 0 D
I

ADDITIONAL SCREENING REQUIREMENTS LETTER ISSUED

TUPEINFO

I DATE OF TRANSFER

1I PREVIOUS COMPANY

ICONTINUOUS SERVICE

IISITE

NAME

PAPERWORK FORWARDED TO
IINVITE SIGNATURE

ACCOUNTS

I
UNIFORM RETURNED Y/N REASON FOR LEAVING RE EMPLOY Y IN

SCREENING CONTROL

D D D

I
DATE OPERATIONS PERSONNEL

LEAVERS INFO

DEPARTMENTS INFORMED ACCOUNTS SIGNED

LEAVING DATE

VSS-FRM-301

Issue:1

12104/2011

ISURNAMEIFAMILY NAME

IITITLE

HAVE YOU WORKED FOR VSS BEFORE IF YES FROM HAVE YOU APPLIED TO VSS BEFORE IF YES, WHEN:

YES NO TO YES NO

0 0 0 0 0 0 0

I FORENAM ECS)

IIMATE/FEMALE

!PREVIOUS SURNAME

II

DATE OF BIRTH

ARE YOU SEEKING SECURITY

FT OPT RECEPTION OTHER

ADDRESS HOW DID YOU HEAR ABOUT THIS POSITION?

IF THIS WAS A VSS EMPLOYEE PLEASE PROVIDE COMPLETE NAME

POST CODE

NEAREST TRAIN STATION

DATE ANY HOLIDAYS BOOKED

HOME TELEPHONE MOBILE EMAIL

NAME AND ADDRESS OF NEXT OF KIN (IN CASE OF EMERGENCY)

I I

NATIONAL

HOW RELATED:

INSURANCE No. NATIONALITY . !!VISA TYPE

HOME TEL:

WORK TEL:

EXPIRY

IPLACEOFffi~H~OWNANDOOU~~)II;D;A;T;E~O;F~E;N;T;R;Y;I;N;U;K;==========~!;!P;A;S;S;P;O;R;T;N;O=.===========~

DO YOU HAVE A DRIVING LICENCE: DRIVING LICENCE No:

FULL

PROVISIONAL

IF YES, WHICH CLASS: CAR MOTORCYCLE DETAILS OF CURRENT ENDORSEMENTS:

D NO 0

WE REQUIRE A CONTINUOUS RECORD OF YOUR PREVIOUS ADDRESS FOR THE LAST 5 YEARS PREVIOUS ADDRESS 1: PREVIOUS ADDRESS 2:

FROM

TO

FROM

TO

DETAILS OF SIA LICENCE: SIA LICENCE No. SIA LICENCE TYPE PLEASE READ THIS SECTION CAREFULLY AND SIGN HAS A COUNTY COURT JUDGEMENT EVEOEEN AWARDED AGAINST YOU? YES IF Y NO SIA LICENCE EXPIRY DATE

GIVE DETAILS: DATE:

HAVE YOU EVER APPEARED BEFORE A COURT, CHARGED WITH A CRIMINAL, CIVIL OR MILITARY OFFENCE AND BEEN CONVICTED, OR CAUTIONED BY THE POLICE, FOR ANY YES OFFENCE WHICH IS CONSIDERED AN UPSPENT CONVICT NO IF YES GIVE DETAILS AND DATES: HAVE YOU ANY ALLEGED OFFENCES OUTSTANDING? IF YES GIVE DETAILS AND DATES:
VSS-FRM-301

0 0 0 0

SIGNATURE: SIGNATURE:

YES NO

SIGNATURE: SIGNATURE:

Issue:1

12/04/2011

SERVICE RECORD N/A D

ARMYD

NAVYD
YES

AIR FORCED POLICE SERVICED FIRESERVICED TERRITORIAL ARMY D D

NO

ARE YOU LIABLE FOR RECALL

ARE YOU A MEMBER OF ANY RESERVE

INVOLVING

TRAINING

YES

NO

CHARACTER REFERENCES
PLEASE GIVE DETAILS OF 2 PEOPLE (OTHER THAN FAMILY AND NOT A FORMER EMPLOYER), MINIMUM OF 3 YEARS. WE WILL APPROACH YOUR EMPLOYMENT NAME: ADDRESS: HISTORY. NAME: ADDRESS: FOR REFERENCES WHO HAVE KNOWN YOU FOR A CERTAIN PERIODS OF AND IF NEED BE, TO ASSIST IN VERIFYING

TELEPHONE OCCUPATION:

No.

TELEPHONE OCCUPATION:

NO.

PERIOD KNOWN:

PERIOD KNOWN: (STATE NAME AND ADDRESS No. OF ALL SCHOOLS/COLLEGES ATTENDED WIHIN LAST 5 YEARS) OFFICE USE GAINED

EDUCATION AND QUALIFICATIONS

DATES FROMITO SECONDARY INCLUDING FULL ADDRESS

SCHOOUCOLLEGE/UNIVERSITY AND TELEPHONE

EXAMS TAKEN QUALIFICATION

EMPLOYMENT
EMPLOYMENT MONTHIYEAR FROM: TO: TEL:

- FIVE YEARS HISTORY

DETAILS OF EMPLOYMENT, UNREGISTERED COMPANY ADDRESS: NAME:

STARTING

WITH TODAY'S

DATE AND WORKING

BACKWARDS OFFICE USE

DATES

SELF EMPLOYMENT, MILlLARY

REGISTERED/UNREGITERED/ PART TIME WORK HELD

UNEMPLOYMENT,

SERVICE,

POSITION WORKS

No. TO:

REPORTING

LAST SALARYIWAGE: FAX: POSTCODE: FROM: TO: TEL: COMPANY ADDRESS: NAME: POSITION HELD REASON FOR LEAVING:

WORKS No. REPORTING TO:

FAX: POSTCODE: FROM: TO: TEL: COMPANY ADDRESS: NAME:

LAST SALARYIWAGE: REASON FOR LEAVING:

POSITION WORKS

HELD

No. TO:

REPORTING FAX: POSTCODE: FROM: TO: TEL: COMPANY ADDRESS: NAME: POSITION WORKS

LAST SALARYIWAGE: REASON FOR LEAVING:

HELD

No. TO:

REPORTING FAX: POSTCODE:

VSS-FRM-301

LAST SALARYIWAGE: REASON FOR LEAVING:

Issue:1

12/04/2011

EMPLOYMENT
EMPLOYMENT MONTHIYEAR FROM: TO: TEL:

- FIVE YEAR HISTORY (CONTINUED)

DETAILS OF EMPLOYMENT, UNEMPLOYMENT, MILITARY SELF EMPLOYMENT, SERVICE, REGISTERED/UNREGISTERED/ UNREGISTERED OFFICE USE

DATES

PART TIME WORK, ETC.

ADDRESS:

WORKS

No. TO:

REPORTING

LAST SALARY/ WAGE: FAX: POSTCODE: FROM: TO: TEL: COMPANY ADDRESS: NAME: POSITION HELD REASON FOR LEAVING:

WORKS No. REPORTING TO:

FAX: POSTCODE: FROM: TO: TEL: COMPANY ADDRESS: NAME:

LAST SALARYIWAGE: REASON FOR LEAVING:

POSITION WORKS

HELD

No. TO:

REPORTING FAX: POSTCODE:

LAST SALARYIWAGE: REASON FOR LEAVING:

PLEASE READ THIS SECTION CAREFULLY BEFORE YOU SIGN THE STATEMENTS
OFFICE USE ONLY ARE YOU ABLE AND FIT TO WORK NIGHT SHIFTS REFERENCE DECLARATION SIGNED SIGNED

DATA PROTECTION STATE: YES NO

STATEMENT

D
D D

SIGNATuRE: SIGNATURE:

~EQUAL

OPPORTUNITIES

FORM SIGNED

BANK DETAILS FORM FILLED

STATEMENT TO BE SIGNED BY APPLICANT

1 2 3 4 5 IF OFFERED EMPLOYMENT, IT WILL INITIALLY BE FOR A PROBATIONARY PERIOD OF 12 WEEKS MAY BE TERMINATED TRAINING BY YOU (EXCEPT IN CASE DURING THE PROPATIONARY OF GROSS MISCONDUCT), CONTINUED EMPLOYMENT (IF REQUIRED) CUSTOMER BY YOU. PLEASE SIGN BELOW TO INDICATE THAT YOU HAVE READ UNDERSTOOD APPLICANTS SIGNATURE.:....: _ THE ABOVE 5 POINTS IN THIS STATEMENT. DATE PERIOD, YOUR CONTRACT IS CONDITIONAL OF EMPLOYMENT

BY NOT LESS THAN 2 WEEKS NOTICE. UPON SATISFACTIORY SCREENING, POLICY WILL BE INSTIGATED AGAINST ANY AND A MEDICAL EXAMINATION TO THE TERMS AND CONDITIONS THE COMPANY'S USE ONLY. CRIMINAL OF EMPLOYMENT. PROCEEDINGS

AND ADHERENCE

I HAVE READ AND UNDERSTOOD TELEPHONES

EQUAL OPPORTUNITY

ARE FOR BUSINESS

MEMBER OF STAFF WHO IS REASONABLY

SUSPECTED

OF THIS OFFENCE AND YOU WILL BE LIABLE FOR ANY COST INCURRED

-----

STATEMENT TO BE SIGNED BY APPLICANT

1, ----------THE INFORMATION PROVIDED IS COMPLETE AND CORRECT AND I UNDERSTAND DISMISSAL AND RENDERS THAT

(FULL NAME IN CAPITALS) CERTIFY THAT TO THE BEST OF MY KNOWLEDGE, PRESENTATION PROSECUTION. IN ORDER TO COMPLETE CREDIT REFERENCE THE EMPLOYEE OF ANY FALSE INFORMATION

OR DOCUMENTS

IS GROUNDS

FOR IMMEDIATE

ME LIABLE TO

SCREENING

TO THE BS7858 STANDARD

I AUTHORISE

THAT ORGANISATION

TO APPROACH

THE GIVEN

BUREAU, ANY AGENCIES, DECLARATION

FORMER EMPLOYERS IF REQUIRED.

AND PERSONAL

REFERENCES

TO VERIFY THE INFORMATION

AND WILL SUPPLY A STATUTORY APPLICANTS SIGNATURE.:....:

DATE

VSS-FRM-301

Issue:1

12/04/2011