Application Form Please complete the application form here and we will be in touch. Which position are you applying for? * Patient Transfer Crew (Zero Hours Contract) Drivers Licence essential Part Time Schools Driver (Approx 15-25 Hrs per week) Part Time Schools Escort (Approx 15-25 Hrs per week) Title * Name * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Date of birth * MM DD YYYY Email * Phone * (###) ### #### Right to work in the UK * Yes No Other (Permits/Certificates/ID Cards) Full UK Driving Licence * Yes No Points or Disqualifications Yes No Details Illnesses or Disabilities * Yes No Details Criminal convictions * Yes No Details This post is exempt from the Rehabilitation of Offenders Act 1974 and therefore all convictions, cautions and bind-overs, including those regulated as 'spent', must be declared. Three year work history - Previous Employer * Position * Address * Email * Start date * MM DD YYYY End date * MM DD YYYY Reason for leaving * Previous Employer * Position * Address * Email * Start date * MM DD YYYY End date * MM DD YYYY Reason for leaving * Education / Skills * NVQ in relevant subject i.e. childcare, social care, transport Yes No Subject First Aid Certificate * Yes No Manual Handling Certificate * Yes No Do you hold an Enhanced DBS Certificate? * Yes No Newark & Sherwood Private Ambulance Badge? * Yes No If so, please give your licence number DATA PROTECTION Employment. BN Gibson Ltd will keep the information you have supplied confidential and will not divulge it to third parties, except where required by law, or where we have obtained the services of a third party representative to act on your/our behalf. Your application form will be kept on file for six months and then destroyed unless you give us an alternative instruction. Information about how we process and store your data can be found on our Privacy Policy linked below, alternatively you can request a paper copy. I agree I have read the Data Protection notification above and understand and agree to the use of my personal data in accordance with the General Data Protection Act May 2018. I understand that any false or misleading information given in this application form may result in any offer or subsequent employment being terminated. By submitting this application form, I confirm I have read and agree to all the above and all of the information I have given is true to the best of my knowledge. Please tell us why you'd like to apply for this role * Thank you!
