Complete Protection Consultants Ltd
Filling in this Application Form:
Please answer ALL questions in BLOCK CAPITALS in your own handwriting and use BLACK INK. Also if require regards extra
information and detail please use a CPC/HR/01AFX form.
Full Name: ………………………………………………………………………
Date of Birth: ……………………………………………………………………
Affix your photograph
here
Home Address: ………………………………………………………………….
…………………………………………………………………………………...
…………………………………………………………………………………..
Mobile No: ……………………………………………………………………..
INTRODUCTION: CPC Ltd, as a company we endeavour to keep all our successful applicants in either full or part time contract,
which ever they are seeking. When filling in this application form please take your time as we ask for extensive information. This is
due to the diversity of our company and your information is crucial not only for us but it may ensure your availability to fill a vacant
position. We ask you to list your previous skills, employment along with many other questions which will be advantageous to both
you and the company. Within this application form there is a section where you may summarise your wishes to further your career,
or another avenue of work available through our company. You may wish to gain your First Person on Scene Intermediate
certificate, enrol in one of our Close Protection Operative courses or even a Microsoft course. The company brochure will give you
most of the information you require also our coverage Worldwide, speak to your interviewer regards furthering your carrier. CPC
Ltd, are always looking to improve services or move into different areas of opportunity and request you give us feedback. If your
application is successful you become part of a unit with the added bonus, if your suggestions/ideas to better our services or
introductions onto further contracts are successful we offer either financial rewards or many other incentive related bonuses.
Position applied for, at interview; ……………………………………………
Employment start date; …………………………….
Title: Mr / Mrs / Miss / Ms (circle one)
Surname:
Surname at birth (if different from above):
Forenames:
Date of name change:
Previous
Address if at
present
address less
than 3 years
Telephone No:
Mobile No.
Other No.
Postal code:
Date of birth:
Email address:
Place of birth:
Nationality:
Religion:
National Insurance No:
Passport No:
Place of entry into UK: (if applicable)
Are you permitted to work in the UK?
YES / NO
Date of entry into
UK:
Visa No. and
expiry date: (if
applicable)
SIA Licence:
YES / NO
Licence type:
Licence No:
Expiry date:
Company and address, you carried out SIA training & examination with;
Where did you hear about the vacancy? Job Centre, LinkedIn, Facebook, Gumtree, University, through a friend, please state.
CPC/HR/002AF
Page 1
PERSON TO CONTACT IN AN EMERGENCY:
Name:
Relationship:
Address:
Work tel. No:
Home tel. No:
Mobile tel. No:
Postal code:
EQUAL OPPORTUNITIES:
This section is voluntary and will NOT be used in assessing your application. We are an equal opportunities employer and if you choose to
complete this section it will help us to monitor the effectiveness of our Equal Opportunities Policy.
My ethnic origin is (please
African, Asian, Caribbean, Caucasian, Other (please specify)
circle)
DIETARY REQUIRMENTS: If you have any special dietary requirements please state, Vegetarian, Vegan, Halal, etc.
DRIVING LICENCE:
Full / Provisional / None (please circle)
Please state
categories:
Own transport: YES / NO
Driving
Licence No:
Have you ever been disqualified from driving? YES / NO (please circle)
Details of motoring convictions or endorsements in the last 5 years, PLEASE NOTE ANY DRUNK DRIVING CONVICTION IN THE
LAST 20 YEARS MUST BE LISTED:
OFFENCES, CAUTIONS AND CONVICTIONS. NB. Disclosure is not required where there is a conviction to which the provision of
the Rehabilitation of Offenders Act 1974 applies. Failure to disclose an unspent
conviction may result in summary dismissal. If you are unclear about any of these questions ask the interviewer or the HR Dept.
Have you been cautioned by the Police?
YES /NO
Have you been convicted, fine or any orders made against you?
YES /NO
Are you aware of any Police investigation?
YES /NO
If the answer is YES to any of the above 3 questions please give details.
NB. Disclosure is not required where a conviction to which the provision of Rehabilitation of Offenders Act 1974 applies. Failure to
disclose an unspent conviction may result in summary dismissal. If you are unclear about any of these questions ask the interviewer.
FINANCIAL: BS 7858:2012 requires we conduct a Consumer Information Check with a credit reference agency.
Have you ever been declared bankrupt or insolvent?
YES / NO
Are you the subject of any County Court Judgment or proceedings?
YES / NO
If the answer is YES to either of the 2 question above please give details.
CPC/HR/002AF
Page 2
CHARACTER REFEREES
Please give details of two people willing to act as Character Referees who have known you for at least 5 years, (No family, relatives or
persons living at your address or properties owned by you).
Name:
Name:
Address:
Address:
Post code:
Post code:
Tel No.
Tel No.
Email:
Email:
Years known:
Years known:
How known:
How known:
EMPLOYMENT RECORD
We require at least 5 years employment records, which include all periods of employment, unemployment and self-employment.
If stating periods of unemployment when filled in must be accompanied with the address of the Unemployment Benefit Office which you
reported and the type of benefit claim, i.e. Incapacity Benefit, Job Seekers Allowance etc.
Please start with your most recent position.
Employers Details (BLOCK CAPITALS)
Company Name:
Position:
From
To
Month
Month
Address:
Year
Year
Employ No.
Supervisor:
Tel No:
Reason for Leaving:
Company Name:
Position:
Address:
From
Month
Year
To
Month
Year
From
Month
Year
To
Month
Year
From
Month
Year
To
Month
Year
Employ No.
Supervisor:
Tel No:
Reason for Leaving:
Company Name:
Position:
Address:
Employ No.
Supervisor:
Tel No:
Company Name:
Reason for Leaving:
Position:
Address:
Employ No.
Supervisor:
Tel No:
Reason for Leaving:
CPC/HR/002AF
Page 3
Company Name:
Position:
Address:
From
Month
Year
From
Month
Year
From
Month
Year
From
Month
Year
Employ No:
Supervisor:
Tel No:
Reason for Leaving:
Company Name:
Position:
Address:
Employ No:
Supervisor:
Tel No.
Reason for leaving:
SELF EMPLOYMENT, DIRECTORSHIPS.
If you are self-employed and are intending to invoice CPC Ltd please state all information, including a sample invoice.
Company Name:
Address:
Post code:
Tel No.
Company Reg. No.
VAT No.
If you are or have been self-employed or a Director of a company within the last 5 years please state persons who can confirm details. (If
required ask for assistance)
Trade:
Accountant:
Name:
Name:
Address:
Address:
Post code:
Post code:
Tel No.
Tel No.
PLEASE STATE IN THE BOX BELOW YOUR EMPLOYMENT SKILLS (Please use a further sheet if required.
EDUCATION RECORD (please state secondary school and College/University – only complete if attended within the last 5 years.
School:
Qualification:
From
To
Address:
Month
Month
Year
Year
Post code:
Tel No.
CPC/HR/002AF
Page 4
College/University:
Address:
Coarse & Qualification:
From
Month
Year
To
Month
Year
Post code:
Tel No.
FURTHER EDUCATION (Please give as much detail as possible, if required use separate sheet with the heading)
OTHER COURSES, CERTIFICATION, ETC.
Language
English
Very good
Good
Fair
Few words
SERVICE RECORD (complete if you have at any time been in service or have went through training)
ARMY/ ROYAL NAVY/RAF/FIRE BRIGADE/POLICE/TERRITORIAL
From
Month
Year
To
Month
Year
OTHER (specify)
Unit/Regiment:
Service No:
Rank:
Conduct Assessment on discharge:
Are you a member of any reserve that would require regular training or service: YES / NO. If YES state below.
CPC/HR/002AF
Page 5
MEDICAL QUESTIONS;
If YES please give details with approximate timings etc.
All the following information as all your other info will be retained and handled in the strictest confidence. The reason for this Intel is to
protect where reasonably practicable your welfare, health & safety. We may require a covering letter from your GP regards both physical &
mental state.
Please read all question carefully and answer all YES or NO
Epilepsy, fits, fainting or blackouts
Back troubles or pain
Diabetes
Joint, tendon or ligament problems
High blood pressure/heart problems
Problems with standing for long periods
Asthmatic or breathing problems
Problems climbing stairs or gradients
Arthritis, rheumatism or gout
Problems with bending over to lift objects
Hernia of any kind
Any serious fractures or injuries
Typhoid, cholera or paratyphoid
Received any major operations
Yellow fever
Mental or emotional illness
Hepatitis of any kind
Is there any mental illness in your family
Tuberculosis
Are you colour blind of any degree
Eczema or skin troubles
Do you suffer from claustrophobia
Dysentery or recurring diarrhoea
Do you suffer from vertigo
Recurring infections or illness
Have you suffer from any other phobias
Are you currently on prescribed drugs
Vision; do you wear glasses or contact lenses
Hearing; have you difficulty hearing or have a hearing add fitted
Medical treatment; are you receiving any medical treatment at present or are expecting any in the future?
Do you consider yourself physically & mentally fit to work within the security industry?
Over the last 3 years have you received any hospital treatment of any kind?
Over the last 3 years have you been absent for more than 2 weeks from work, school or full time education?
Have you any registered disabilities?
Have you any concerns with your ability to carry out any tasks within your applied job?
Yes answers from above should be noted within this box. If filling on line it will expand, on paper use further sheet if needed.
Due to the nature of some of our work we may require both a physical and mental assessment
Would you be agreeable to a physical medical if required?
YES/NO. If NO please state reason below.
Would you if requested supply a Doctor’s Medical Health letter? YES/NO. If NO please state reason below.
UNIFORM REQUIREMENTS (In order to ensure if we are supplying uniforms we have your required size we request you fill in
the below section)
Height
Example
1.96cm or 6’5”
Chest
Example
X Large or 48”
Waist
Inside Leg
Example
Large or
36”
Example
Long or 34”
Shoe Size
Example
UK 13, US 14
or EUR 49
Agreement to opt out, working time directive. Please print your name is the space after I.
I ______________________________ agree that I may work more than an average of 48 hours per week. If for any reason I wish to end
this agreement, I will give in writing to my employer two months’ notice. Under certain circumstances this may not apply.
Signed; ____________________________________
CPC/HR/002AF
Date; _____________________________
Page 6
IF YOU ARE NOT HANDING A CURRICULUM VITAE, PLEASE FILL IN THE FOLLOWING SECTION AS A PROFILE
STATEMENT, if required attach a CPC/HR/01AFX with further information
KEY SKILLS:
ANY OTHER INFORMATION ABOUT YOURSELF:
Bank details, all payments will be paid into your bank account. If you do not have an account please let us know we could assist.
Name of bank
Name on the account
Sort code
Account number
IBAN
BIC
Please check you have filled in all questions of this application form and signed where applicable. Once completed return to the interviewer,
email to hr@cpcsecurity.co.uk or if posting;
Send to CPC Ltd, Bonnington Bond, 2 Anderson Place, Edinburgh, EH6 5NP. Tel; 0131 515 2065.
Complete Protection Consultants Ltd would like to take this opportunity to thank for taking the time to fill in this extensive application form
also your interest in joining our Company. All the information you state on this application form will be treated with the highest degree of
confidentiality.
Official use; Interviewer, Section Manager,
Print; ____________________________________.
Signed; ___________________________________________.
Position; _________________________________.
Date; ___________.
Time; _________________________.
Comments;
CPC/HR/002AF
Page 7
Official Use, Comments continued,
Official use only; DOCUMENTATION PRODUCED; State which documents, photocopy and scan all.
IDENTIFICATION
Passport size photo (2)
Passport
Driving licence (+ paper part)
National Insurance card.
UK work Visa
Service (gas, electric, telephone etc.), Council or other proof of address;
Birth certificate
Marriage certificate
P45 statement of income tax issued in the last 12 months
P60 annual statement issued in the last 12 months
Bank or Building Society statement to current address
CRB Disclosure
PVG
C VITAE
REFERENCE NO.
TICK
DATE/EXPIRY
PROOF OF SERVICE HISTORY
HM Forces/Service ID number
Discharge papers
Certificate of Service
REFERENCE NO.
TICK
DISCHARGED
LICENCES
SIA Static Guard
SIA Door Supervisor
SIA Close Protection
SIA Cash & Valuables in Transit
SIA CCTV
REFERENCE NO.
TICK
EXPIRY
REFERENCE NO.
TICK
EXPIRY
Shotgun Licence
Firearms Licence
FIREARMS & HOSTILE ENVIRONMENTS
Tactical firearms
Hostile Environment
CPC/HR/002AF
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MEDICAL
First Aid At Work
First Person On Scene (Intermediate)
Medical in Remote Areas (MIRA)
REFERENCE NO.
TICK
DATE/EXPIRY
VACCINATIONS
Yellow Fever
Hepatitis A
Diphtheria
Tetanus
Polio
Typhoid
REFERENCE NO.
TICK
DATE/EXPIRY
MARITIME
Seaman’s card
Discharge book
ENG1 medical
STCW95, 4 modules
SSO
CSO
MSO (City & Guilds)
REFERENCE NO.
TICK
EXPIRY
LETTERS OF REFERRENCE
Personal
Employer
REFERENCE NO.
NUMBER
DATED
OTHER
REFERENCE NO.
TICK
DATE/EXPIRY
Mental Health Doctor’s Letter
Interviewer; please ensure the application is completed and all paperwork, certificates, qualification etc. are all copied and scanned.
CPC/HR/002AF
Page 9
Complete Protection Consultants Ltd
CONTRACT INFORMATION: This information is required to ensure that you are suitable to contract with the Company to provide
Security services. If you do contract with the Company to provide services you will do so as a contractor, and not as an employee and the
terms in this paragraph will be incorporated into each contract. You are under no obligation to offer your services or accept work offered and
the Company is under no obligation to accept your offer of services or provide you with work at any time. If you do chose to work with the
company each engagement shall constitute a separate contract for services If you cannot fulfil your duties under a contract you should arrange
for a suitably trained qualified person to work as your substitute. You will be paid an hourly rate and to avoid administration difficulties the
company has already calculated the hourly rates to take account of the fact that you are entitled to four weeks paid holiday each year. For the
avoidance of doubt, you will therefore not receive pay for the periods when you are off on holiday. You have already been paid for such
holiday entitlement within your hourly rate. You agree that the company has the right to deduct from any sums due to you, any sums that you
owe the company.
SCREENING: In accordance with the Security Industry standards staff will be screened in accordance with BS7858:2012. From the start of
the screening process we have 12 weeks to complete all aspects of the screening process. If at the end of the 12 week process any aspect of the
screening process is not complete then your provisional employment will be terminated. You can assist the screening process by being aware
of the following and where possible assisting.
A. Character References - To complete the screening process we must have a minimum of 2 x Character References, in writing. Character
References cannot be from a relative or anyone living at the same address as you. They must have known you for a minimum of 2 years and of
the last 5 year period.
B. 5 Year History - We must have in writing a verified 5 year history. In that 5 year period we cannot have any gaps unaccounted for in excess
of 28 days. Ways in which you can assist with this are as follows:
1. If you are or have been registered Unemployed then contact your Job Centre and obtain a letter stating the dates you were in receipt of
benefits or registered unemployed
2. Ensuring that you have provided clear and correct previous employer details.
3. Where a previous employer may no longer exist have to hand any old pay slips. P - 60’s, contract of employment, previous references, etc.
4. If unemployed but not registered as being unemployed or travelling abroad, etc. make this clear on the application form and discuss with
your interviewing officer. It is important that you are honest and work with your interviewing officer / recruitment team.
If there are any indications of dishonesty or deception this may lead to your application or provisional employment being terminated! At
present the Stewards role does not require a fully verified 5 year history as part of their screening process. However, if they progress to
become a S.I.A. Licence holder then they will have to meet this standard even though they may already be employed by the company,
therefore, steward applicants should still provide a complete 5 year history in their application form.
DECLARATION: I understand that employment with the Company is subject to the company obtaining satisfactory references and the
successful completion of security screening in accordance with BS 7858:2012. I will fully co-operate and assist the Company in providing any
additional information required to meet these criteria. I authorise the Company to approach previous employers, schools/colleges, character
referees or Government Agencies to verify that the information I have provided is correct. I authorise the Company to undertake a consumer
information search with a credit reference agency in accordance with BS 7858:2012. I understand and agree that if so required I will make a
Statutory Declaration in accordance with the provisions of the Statutory Declarations Act 1835, to confirm previous employment or
unemployment. I understand that some of the information I have provided in this application will be held on a computer and some or all will
be held in manual records. I consent to the Company’s reasonable processing of any sensitive personal information obtained for the purposes
of establishing my medical condition and future fitness to perform my duties. I accept that I may be required to undergo a medical examination
where requested by the Company. Subject to the Access to Medical Records Act 1988, 1 consent to the results of such examinations to be
given to the Company. I hereby certify that, to the best of my knowledge, the details 1 has given in this application form are complete and
correct. I understand that any documents produced as evidence of identity and proof of residence may be examined using an Ultra violet
scanner or other methods to aid in identifying theft and fraud. Any suspect documents will be reported to the relevant authorities. I understand
that any false statement or omission to the Company or its representatives may render me liable to dismissal without notice. I understand that I
must be 18 or over to apply for a position with Complete Protection Consultants Ltd.
PRINT NAME:
SIGNATURE:
DATE:
Interview conducted by:
Signature:
Date:
CPC/HR/002AF
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