Job Application – Controlled Solutions Group

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Title

Section 1 - Personal Information

First Name

Surname

Previous Names (If Applicable)

Date of Birth

Current Address (Including Postcode)

Date Moved Into Current Address

Email Address

Mobile Telephone

Home Telephone

National Insurance Number

Country & Place of Birth

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Section 2 - Emergency Contact

Full Name

Relationship to You

Contact Number

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Section 3 - Criminal History

Have you ever appeared before a court and been convicted of a criminal, civil, military or morting offence?

Please give details in the space below:

DBS Renewal - Every 3 years CSG will need you to update your DBS, once you renew your SIA you will also need to send CSG both copies of your SIA renew badge and DBS.

Yes, I will provide my SIA / DBS renewal every 3 years to CSG.

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Section 4 - Personal History

Sub Title

YOU MUST PROVIDE US WITH A COMPLETE HISTORY OF YOUR EDUCATION, EMPLOYMENT AND UNEMPLOYMENT OVER THE PAST 5 YEARS.

NOTICE: FOR PERIODS OF REGISTERRED UNEMPLOYMENT, PLEASE GFIVE THE DETAILS OF THE UNEMPLOYMENT OFFICE TO WHICH YOU REPORTED.

NOTICE: PLEASE STATE 'UNEMPLOYED' IF YOU WERE NOT REGISTERED WITH AN UNEMPLOYMENT OFFICE.

NOTICE: THERE MUST BE NO GAPS IN YOUR 5-YEAR HISTORY OF MORE THAN 31 DAYS.

Title

1

Employer Name, Full Postal Address & Telephone

Person You Reported To

Position Held

Full Employment Dates From

Full Employment Dates To

Reason for leaving

Title

2

Employer Name, Full Postal Address & Telephone

Person You Reported To

Position Held

Full Employment Dates From

Full Employment Dates To

Reason for leaving

Title

3

Employer Name, Full Postal Address & Telephone

Person You Reported To

Position Held

Full Employment Dates From

Full Employment Dates To

Reason for leaving

Title

4

Employer Name, Full Postal Address & Telephone

Person You Reported To

Position Held

Full Employment Dates From

Full Employment Dates To

Reason for leaving

Title

5

Employer Name, Full Postal Address & Telephone

Person You Reported To

Position Held

Full Employment Dates From

Full Employment Dates To

Reason for leaving

Do you need more boxes?

Title

6

Employer Name, Full Postal Address & Telephone

Person You Reported To

Position Held

Full Employment Dates From

Full Employment Dates To

Reason for leaving

Title

7

Employer Name, Full Postal Address & Telephone

Person You Reported To

Position Held

Full Employment Dates From

Full Employment Dates To

Reason for leaving

Title

8

Employer Name, Full Postal Address & Telephone

Person You Reported To

Position Held

Full Employment Dates From

Full Employment Dates To

Reason for leaving

Title

9

Employer Name, Full Postal Address & Telephone

Person You Reported To

Position Held

Full Employment Dates From

Full Employment Dates To

Reason for leaving

Title

10

Employer Name, Full Postal Address & Telephone

Person You Reported To

Position Held

Full Employment Dates From

Full Employment Dates To

Reason for leaving

Sub Title

NOTICE: IF YOU WERE SELF-EMPLOYED, PLEASE USE THE SPACE BELOW TO GIVE THE NAME AND ADDRESS OF SOMEONE WHO CAN CONFIRM YOUR SELF-EMPLOYMENT HISTORY (E.G. AN ACCOUNTANT OR SOLICITOR)

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Section 5 - Address History

Sub Title

PLEASE USE THE SPACES BELOW TO GIVE YOUR ADDRESS HISTORY OVER THE PREVIOUS FIVE YEARS.

Title

1

Address Line 1

Address Line 2

Postcode

Dates From

Dates To

Title

2

Address Line 1

Address Line 2

Postcode

Dates From

Dates To

Title

3

Address Line 1

Address Line 2

Postcode

Dates From

Dates To

Title

4

Address Line 1

Address Line 2

Postcode

Dates From

Dates To

Title

5

Address Line 1

Address Line 2

Postcode

Dates From

Dates To

Do you need more boxes?

Title

6

Address Line 1

Address Line 2

Postcode

Dates From

Dates To

Title

7

Address Line 1

Address Line 2

Postcode

Dates From

Dates To

Title

8

Address Line 1

Address Line 2

Postcode

Dates From

Dates To

Title

9

Address Line 1

Address Line 2

Postcode

Dates From

Dates To

Title

10

Address Line 1

Address Line 2

Postcode

Dates From

Dates To

Title

Section 6 - School / College Details

Sub Title

NOTICE: THIS SECTION ONLY APPLIES IF YOU HAVE LEFT SCHOOL AND/OR COLLEGE WITHIN THE PREVIOUS FIVE YEARS.

School Name

Town/City

Date Of Leaving

College Name

Town/City

Date Of Leaving

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Section 7 - Medical Information

Please give details of any illness or disability.

Sub Title

EMPLOYEES WORKING ON NIGHT DUTIES MAY BE REQUIRED TO UNDERTAKE A MEDICAL. FOR FURTHER INFORMATION, PLEASE CONTACT THE HEAD OFFICE.

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Section 8 - Declaration

Sub Title

READ THIS SECTION CAREFULLY BEFORE YOU SIGN THE STATEMENT.

Sub Title

IF YOU ARE OFFERED EMPLOYMENT, IT WILL INITIALLY BE FOR A PROBATIONARY/SCREENING PERIOD OF SIXTEEN WEEKS.

DURING THE PROBATIONARY/SCREENING PERIOD, YOUR CASUAL WORKER STATUS MAY BE TERMINABLE BY THE COMPANY.

CONTINUED EMPLOYMENT IS CONDITIONAL UPON SATISFACTORY SCREENING, MEDICAL AND GENERAL PERFORMANCE.

Certification

I certify that, to the best of my knowledge, the information I have given is complete and correct. I understand that misrepresentation of facts is grounds for immediate dismissal and renders me liable for prosecution. I authorise the company to approach any government agencies, former employers, credit agencies and personal referees to verify the information given. I will supply a statutory declaration, if required.

Fullname (Including Middlenames)

Signature Of Applicant

Date

Do you give consent for the company to approach your current employer?

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Section 1 - Personal Information

Section 2 - Emergency Contact

Section 3 - Criminal History

Section 4 - Personal History

1

2

3

4

5

6

7

8

9

10

Section 5 - Address History

1

2

3

4

5

6

7

8

9

10

Section 6 - School / College Details

Section 7 - Medical Information

Section 8 - Declaration