Tel: +44 (0)1274 600 730 · Email: sales@shipleytransport.co.uk

Driving Vacancies Application Form

Please take the time to fill out the below form:

Fields marked with (*) are required.

Date of application (dd/mm/yyyy) (*):
Position applied for (*):
Surname (*):
Forename(s) (*):
Male/Female (*):
Full postal address (inc postcode) (*):
Telephone number (inc STD code) (*):
National Insurance Number:
Marital Status:
Date of Birth (dd/mm/yyyy):

General Information

Are you in general good health? Yes No
If NO, please state your medical condition:
Are you receiving any medical treatment? Yes No
If YES, please state what treatment:
Have you in the past had periods of ill health resulting in absence from work? Yes No
If YES please state illness and duration:
Are you registered as disabled? Yes No
If YES please give registered number and expiry date:
Are you willing to undergo a medical examination if required? Yes No
Do you have a clean driving license? Yes No
If NO, list endorsements:
Do you hold a valid, clean commercial vehicle driving licence? Yes No
If NO, list endorsements:
Have you ever been convicted of a crime resulting in a prison sentence (actual or suspended)? Yes No
If YES, please give details:
Are you legally eligible for employment in the UK? Yes No
Have you been employed by this company before? Yes No
If YES, give job titles, dates and reason for leaving:

References

Please provide details of 2 people who are willing to provide references, one of which must be your last employer.

Name:
Position:
Company and Address:
Telephone number:
Name:
Position:
Company and Address:
Telephone number:

Employment History

Please give details of your last four positions, starting with your most recent.

From/to:
Employer address and telephone number:
Job title and brief description of duties/responsibilites:
Reason for leaving:
From/to:
Employer address and telephone number:
Job title and brief description of duties/responsibilites:
Reason for leaving:
From/to:
Employer address and telephone number:
Job title and brief description of duties/responsibilites:
Reason for leaving:
From/to:
Employer address and telephone number:
Job title and brief description of duties/responsibilites:
Reason for leaving:

Education

Name of School/
College/University:
From/to:
Qualifications:
Subject:
Name of School/
College/University:
From/to:
Qualifications:
Subject:
Name of School/
College/University:
From/to:
Qualifications:
Subject:

Additional information

Please use the box below to provide us with any additional information you think may help your application.

Declaration (*)

It is understood and agreed that any misrepresentation by me on this application form will be sufficient cause for cancellation od this application and/or termination from the employers service if I have been employed.

I give the employer the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability the employer and its representatives for seeking such information and all other persons, corporations or organisations for furnishing such information.

The employer is an Equal Opportunities Employer. The employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicants consideration for employment on a basis prohibited by law.

I agree: