PROSEC CONSULTANCY LIMITED
SCREENING AND VETTING PROFORMA
It is now our legal obligation to update our records and in accordance with the Private
Security Industry Act 2001, Prosec are now fully authorised to carry out Screening and
Vetting to all Employed and Sub-Contracted (Self-Employed) staff in compliance with the
British Standards BS7858 2007 regulations. Whether you are new to Prosec or an existing
Employee or Sub-Contractor it is our duty to carry out a full Screening and Vetting process
prior to any person working for our company.
Please answer ALL the questions in BLOCK CAPITALS. Insert N/A if any part does not apply
to you and please DELETE where appropriate
Section One – PERSONAL DETAILS
Title: Mr / Mrs / Miss / Ms / Other………………………………………………………………………………..
Surname.………………………………..Forename(s).……………………………………………………………………
Previous Surname……………………………………
Address………………………………………………………………………………………………………………………………
…………………………………………………………………………………………… Post Code …………………………
Contact Details (Home)………………………………………………………. (Mobile)……………………………….
Date of Birth…………………………………….. Place of Birth (town/city)………….……………………………
Nationality ………………………………………. Email..........................................................................
If not born in the U.K please state date of entry …………………………………………………………………
Do you need a work permit
Yes / No
Is the permit valid
Yes / No
Marital Status …….Married / Single / Divorced / Separated / Widowed / Co Habiting
Please list No of Dependants ……………………………………………………………………………………………..
Home status ………… Homeowner / Tenant / Living with Parents
Home Details………… House / Flat / Bungalow / Other ………………………………………………………..
(Amend 07 Jan 2011)
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(EV102)
Section Two – PERSONAL INFORMATION
National Insurance Number …… ……
…… ……
…… …… …… …… ……
Do you hold a full U.K driving licence
Yes / No
If yes: Licence No ……………………………………………………………………………………
Cat …….. A / B / C / D / C1 / CE / DE / BE / D1E/ Other……………………………(Please Circle).
Valid until …………………………..
Do you have your own transport
Yes / No
Have you any driving convictions
Yes / No (if yes please list details and expiry date?)
…………………………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………………….
Uniform size (Please circle)
S
M
L
XL
XXL
XXXL
XXXXL
Do you hold a current U.K passport Yes / No
Passport No………………………………………………………………….Expiry Date……………………………
Do you hold a valid First Aid Certificate
Yes / No
If yes: Valid Until………………………………………Course Name…………………………………………….
Do you hold a current SIA Licence
Yes / No
SIA licence No …………………………………………….Cat: CP / DS / SG / Other…………….(Please State)
SIA Expiry Date ………………………… (DDMMYYYY).
Next of Kin (Full Name) ………………………………………………………………………………………………..
Relationship………………………………………………..
Address (if different from above)………………………………………………………..………………………….
.…………….……………………………………………………………………………………………………………………….
………………………………………………………………………………….Post Code ………………………………….
Contact No (Home) ……………………………………………… (Mobile) ………………………………………
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Section Three – MEDICAL HISTORY
Please Delete as necessary from the list below any medical condition you may suffer from or
have suffered from in the past.
Asthma
Y/N
Epilepsy Y/N
Back Trouble
Y/N
Bronchitis
Y/N
Hay Fever Y/N
Migraines
Y/N
Skin Disorder
Y/N
Faintness Y/N
Nervous Disorder Y/N
Heart Trouble
Y/N
Fits
Diabetes
Rheumatic Complaints
Y/N
Y/N
Y/N
Please give details and approx date of any serious illness, injury or operation you may have
had in the past 5 years:
……………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………
Are you currently receiving medical treatment (if yes please give details) Y/N
If yes ……………………………………………………………………………………………………………………………………
Are you required to wear glasses Y/N
If yes please state permanent or other ……………………………………………………………………………….
Do you Smoke Y/N
How would rate your health
Poor / Good / Excellent
Section Four – Education
Please give the details of your establishment where you received your education
(We only require this if you were in full / further education since June 2003)
Name of School / College or University…………………………………………………………………………………………….
Address…………………………………………………………………………………………………………………………………………….
Phone Number…………………………………………………………………………Post Code ……………………………………..
Dates attended: From………………………………………………………………To…………………………………………………..
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(Amend 07 Jan 2011)
Section Five – Service Record
Have you been part of any British Services? Y/N
Please delete where possible:
Royal Navy / Royal Marine / Merchant Navy / British Army / Royal Air Force / Police / Fire Brigade
Ambulance Service / Coastguard /Reservist in any of the above
Regiment / Corps / Unit / Force ………………………………………………………………………………………………………
Rank on discharge………………………………………..
Service Number…………………………………………….
Conduct Record……………………………………………
Dates From……………………… To……………… (YYYY)
Reason for leaving……………………………………………………………………………………………………………………………
Are you still an active reservist Y/N
If yes, with what unit / brigade / station………………………………………………………………………………………….
Are you liable for call up or have you volunteered for duty …………………………………………………………….
Section Six – Employment History
Please complete this section in full including gaps between employment stating reasons.
(Please list employment history IN REVERSE ORDER from 2005 to give 5 years checkable
employment history)
Name of Employer ………………………………….................. Position Held…………………………………………….
Address………………………………………………………………………………………………………………………………………….
……………………………………………………………………………….... Post Code …………………………………………………
Date of Employment: From …………………………………………..To………………………………………… (MMYY)
Reason for leaving ………………………………………………………………………………………………………………………….
Name of Employer ………………………………….................. Position Held…………………………………………….
Address………………………………………………………………………………………………………………………………………….
……………………………………………………………………………….... Post Code …………………………………………………
Date of Employment: From …………………………………………..To………………………………………… (MMYY)
Reason for leaving ………………………………………………………………………………………………………………………….
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(Amend 07 Jan 2011)
Name of Employer ………………………………….................. Position Held…………………………………………….
Address………………………………………………………………………………………………………………………………………….
……………………………………………………………………………….... Post Code …………………………………………………
Date of Employment: From …………………………………………..To………………………………………… (MMYY)
Reason for leaving ………………………………………………………………………………………………………………………….
Name of Employer ………………………………….................. Position Held…………………………………………….
Address………………………………………………………………………………………………………………………………………….
……………………………………………………………………………….... Post Code …………………………………………………
Date of Employment: From …………………………………………..To………………………………………… (MMYY)
Reason for leaving ………………………………………………………………………………………………………………………….
Name of Employer ………………………………….................. Position Held…………………………………………….
Address………………………………………………………………………………………………………………………………………….
……………………………………………………………………………….... Post Code …………………………………………………
Date of Employment: From …………………………………………..To………………………………………… (MMYY)
Reason for leaving ………………………………………………………………………………………………………………………….
Name of Employer ………………………………….................. Position Held…………………………………………….
Address………………………………………………………………………………………………………………………………………….
……………………………………………………………………………….... Post Code …………………………………………………
Date of Employment: From …………………………………………..To………………………………………… (MMYY)
Reason for leaving ………………………………………………………………………………………………………………………….
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(EV102)
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Section Seven – References
Please Give ONE personal referee who has known you for a minimum of two years (this
person must not be related to you), and TWO employment referees who you have worked
for and has known for a minimum of 5 years.
Personal Referee
Name ………………………………………………………………………………………………………………………………..
Address ……………………………………………………………………………………………………………………………..
……………………………………………………………………………………… Post Code …………………………………
Occupation ……………………………………………………Tel: ……………………………………………………………
Years Known …………………………………………………Relationship to you ……………………………………
Employment Referees
Name ………………………………………………… Company …………………………………………………………….
Address ……………………………………………………………………………………………………………………………..
……………………………………………………………………………………… Post Code …………………………………
Position Held ……………………………………………………Tel: ………………………………………………………
Years Known …………………………………………………Relationship to you ……………………………………
Name ………………………………………………… Company …………………………………………………………….
Address ……………………………………………………………………………………………………………………………..
……………………………………………………………………………………… Post Code …………………………………
Position Held ……………………………………………………Tel: …………………………………………………………
Years Known …………………………………………………Relationship to you ……………………………………
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(EV102)
(Amend 07 Jan 2011)
Section Eight - Payment Information
In order for Prosec to make sure all payments are made without any issues, please complete
this section in order that we have all the right information regarding the individual.
Is this you’re (please circle)
ONLY JOB
Employment Status (please circle)
PAYE
SECOND JOB
SELF-EMPLOYED
If you have circled Self – Employed please state your Unique Reference ……………………………
(This would have been given to you from the HMRC when you registered yourself as Self-Employed).
Bank Details
Name of Bank ………………………………………………………..
Name of Account Holder….…………………………………….
(Relationship if different from applicant) …………………………………………
Account Number ………………………………………………..
Sort Code
….. …..
…… ……
…… ……
Please inform Prosec as soon as possible of any changes that you make regarding your bank
details as this may cause problems when we need to make any payments to you.
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Section Nine – Declaration
I ………………………………………….. Hereby certify that I have completed this Vetting Form and
that the information given to the best of my knowledge is correct. I understand and give my
permission that Prosec Consultancy Ltd can at any time contact the named person(s) or
establishments to confirm any of the above details, and I give permission for Prosec
Consultancy Ltd to collect, retain and process information regarding myself whilst I am
engaged or appointed to Prosec Consultancy Ltd.
I agree that i may work for more than an average of 48 hours a week set out by the working
time regulations. I therefore agree that if i change my mind in the future i will give Prosec
Consultancy Ltd 1(One), months’ notice in writing to end this agreement.
Prosec Consultancy Ltd is regulated by the Data Protection Act 1998 and respects the
information given to be “sensitive personal data”, (which is “Data” for the purpose of the
Act) about the person who has completed this form.
Signed by Applicant ……………………………………………………………….
Name in full …………………………………………………………………………….
Date …………………………………………………………………. (DDMMYYYY)
Please return this form by post only with a current passport photo to:
Prosec Consultancy Ltd
10 Oakfield Business Centre
Westbury
Wiltshire
BA13 4WF
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(EV102)
(Amend 07 Jan 2011)