URGENT SECURITY SERVICES

LIMITED.
324 Bensham Lane Suite No 309 Thornton Heath Croydon CR7 7EQ
T: 02086649830 F: 02086649830 www.urgentsecurity.co.uk info@urgentsecurity.co.uk
Complete security solution

Surname:

APPLICATION FOR EMPLOYMENT

PLEASE COMPLETE IN BLOCK CAPITALS & USE BLACK INK
Maiden name:
First name/s:

Mr / Mrs / Miss / Ms [delete not applicable]

Position applied for:

Date of Birth:

National Insurance Number:

Age:

Place and Country of Birth:

Where did you hear of the vacancy?

Your Address: _________________________________________________

Tel No: ________________________

_____________________________________________________________

Mobile: ________________________

Post Code:

Pager:

How long have you lived at your current address?

If less than 5 years, what was your previous address? ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Post Code ---------------------------Is your current property, Owned / Rented / Other [please state]:
If you were not born in the United Kingdom, give your date of entry:
Do you require a permit to work?
Marital Status: Married / Single / Divorced / Cohabiting
Next of Kin: [name]

Number of Children:

Relationship:

Ages:

Tel No:

Contact Address of Next to Kin:

Bank Details:--- this information is critical to ensure you are paid correctly
Bank Name: ___________________________________

Account Name: ________________________________________

Branch Address: ____________________________________

Account Number: ______________________________________

Post Code:
Do you have any criminal convictions?

Sort Code:
Have any Civil Proceedings been brought?

If the answer to any of above is YES, give full details [a copy of CRO file may be required]
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Do you have your own transport?
Driving License Number:
Please give full details of all driving convictions, including Fixed Penalty Notices
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

MEDICAL HISTORY: You must answer YES or NO in each box as appropriate:

Do you have any disability or difficulty with any of the following?
Sight:
Color vision:
Hearing:
Smell:
Mobility:
SECURITY TRAINING:
Do you suffer from any medical condition that could affect your ability to work DAYS or NIGHTS on single manned sites?
Have you received any Security training?
Who provide you the training?
Epilepsy:
Diabetes:
Heart disease:
Others:
Date training started:
Type Of License
Are you a registered disable person?
RDP Number:
Disability:
Date training finished:
SIA License No
Have you had injections, drugs or pills prescribed by a Doctor, in the last six months?
Have
been
off work,
due to illness,
for more
than one
week in the
last two
years?
What you
do you
think;
your training
needs are,
to become
a successful
Security
Officer?
Have
you ever suffered from a mental illness, nervous breakdown or depression?
---------------------------------------------------------------------------------------------------------------------------------------Have you ever been medically discharged from any employment?

---------------------------------------------------------------------------------------------------------------------------------------Have you been hospitalized in the last ten years?

---------------------------------------------------------------------------------------------------------------------------------------If the answer is YES to any of the above, please give full details:
REFEREES:
_________________________________________________________________________________________
_________________________________________________________________________________________

1. You must provide two independent referees, who have known you personally for a minimum of two years. They will be required to
provideread
written
attesting
to yourIcharacter.
So that misunderstandings
do not
they willDoctor,
also beand
required
to confirm,
Please,
andconfirmation,
sign the following
statement
agree to undergo
a medical examination
byoccur,
the Company
I authorize
Urgent
Security Services
ltd of
. toyou,
contact
my own
Doctor.
that
an enclosed
photograph
is a true
likeness.

DrIt_____________________________________
2.
is not permitted for a member of your family to be a referee, or a current/previous employee of Urgent Security Services ltd .
Telephone Number: ________________________________
Address: ________________________________

1) Full Name _________________________________________

2) Full Name ________________________________________

Address:

Address:

________________________________
_________________________________________
_________________________________________

________________________________________

Applicants Signature:
________________________________________

EDUCATION:
__________________________________
__________________________________
If
you
have
attended
school
/
college
in
the
last
ten
years,
please
give
full
details:
Post code: _________________________________________
Post code:
_________________________________________
Name of school -------------------------------------------------------------------Telephone:

_________________________________________

Address:

Telephone:

_________________________________________

--------------------------------------------------------------------

Occupation: _________________________________________
Occupation: _________________________________________
SELF-EMPLOYMENT
:
-------------------------------------------------------------------If you have never been self employed enter N/A and go to next section : REASONS

--------------------------------------------------------------------

Enter dates of self employment :

From:

To:

Please give the date you left ---------------------------------------------------Please provide two professional referees (accountant, solicitor, Inland Revenue)
QUALIFICATIONS:
Please give details of all qualifications [including GCSEs stec]:
1)
Full Name _________________________________________
2) FullBody
Name/ _________________________________________
Qualification
Date received
Certification
Place of Education
Address:
_________________________________________
Address:
_________________________________________
_____________
____________
___________________________________________________
_________________________________________
_________________________________________
_____________
____________
__________________________________________________
__________________________________
__________________________________
_____________
____________
__________________________________________________
Post
code:
_________________________________________
Post code:
_________________________________________
_____________
____________
__________________________________________________
Telephone:
_________________________________________
Telephone:
_________________________________________
_____________
____________
__________________________________________________
Professional
status: ____________________________________
Professional status: _____________________________________
_____________
____________
__________________________________________________

_____________
____________
__________________________________________________
Please
read and sign the following
statement:[self-employed
personal only]
_____________

____________

__________________________________________________

I understand that as self-employed person, I have a legal obligation to inform the Inland Revenue of my earnings, and that Urgent
REASONS:
Security Services ltd. will pass any information as required by the Inspector of Taxes:
You must answer all of the following questions :

2
Print Name ------------------------------------------ Signature ------------------------------------ Date --------------------

1. Briefly , give the reasons why you want to work in the Security industry :

2. How do you see yourself in the role of the job applied for?

3. What hobbies, pastimes or sports do you participate in?

5 YEAR HISTORY : please read the following notes carefully and only then proceed with your history
1-As a Security Company, we are required to screen all applicants according to the British Standard 7858-Security screening of
personnel employed in a security environment. That means we have to confirm in writing, your work history for up to 5 years and
account for any gaps in that history. We only have 16 weeks to complete your screening. If we are unable to do so, then your
employment will be terminated. It is therefore critical that you give accurate information and respond quickly to any subsequent
requests for further details.
2- Starting with your present employment, please give full details of your employment history for the previous five years.
3- If you have attended full time education in that time, give full details appropriately.
4- If you have had periods of unemployment, give full details appropriately.
5- You must state your history on a year and month basis. That means you must be able to show continuity of work from month to
month, as well as year-to-year. If you have a gap between jobs, then you must account for that gap appropriately. For example; if you
left one job in May, an did not start your next job until July, you must account for the month of June- use a box, delete Name and
address of employer and write an explanation for the gap.
(Do not proceed with your work history unless you fully understand all of the above.
The interviewer or the Personnel Department [02086649830], will be pleased to help and advise you)
We may contact your present employer for a reference at this time?
1. Name & Address of your current employer/School/College/Univ.
Tel No:.
..
Position held:
..
Work reference No:..
..
Salary:..
..
Date started [month]...[year]
Reason for leaving? ........
To whom did you report? ..
2. Name & Address of your employer /School/College/Univ.
Tel No:.
..
Position held:.
..
Work reference No:..
..
Salary:
..
Date started [month]...[year]
Reason for leaving? .... Date finished[month]..[year]....
To whom did you report? ..

3. Name & Address of your employer/School/College/Univ.

Tel No:.

..
..
..
..
Reason for leaving.
To whom did you report?
4. Name & Address of your employer/School/College/Univ.
..
..
..
..
Reason for leaving.
To whom did you report?
5. Name & Address of your employer/School/College/Univ.
..
..
..
..
Reason for leaving.
To whom did you report?
6. Name & Address of your employer/School/College/Univ.
..
..
..
..
Reason for leaving.
To whom did you report?
7. Name & Address of your employer/School/College/Univ.
..
..
..
..
Reason for leaving.
To whom did you report?
8. Name & Address of your employer/School/College/Univ.
..
..
..
..
Reason for leaving.

Position held:
Work reference No:..
Salary:..
Date started[month]...[year]
Date finished[month]...[year]..
Tel No:.
Position held:
Work reference No:..
Salary:..
Date started[month]...[year]
Date finished[month]...[year]..
Tel No:.
Position held:
Work reference No:..
Salary:..
Date started[month]...[year]
Date finished [month].[year]..
Tel No:.
Position held:
Work reference No:..
Salary:..
Date started[month]...[year]
Date finished [month].[year]..
Tel No:.
Position held:
Work reference No:..
Salary:..
Date started[month]...[year]
Date finished [month].[year]..
Tel No:.
Position held:
Work reference No:..
Salary:..
Date started[month]...[year]
Date finished [month].[year]..

To whom did you report?

9. Name & Address of your employer/School/College/Univ.
Tel No.
.
Position held: .
.
Work reference No:
.
Salary: .
.
Date start [month].. [year]
Reason for leaving ..
Date finished [month] .. .[year] ..
To whom did you report? ..
10. Name & Address of your employer/School/College/Univ.
.
.
.

Tel No.
Position held: .
Work reference No:
Salary: .

.
Date start [month].. [year]
Reason for leaving ..
Date finished [month] .. .[year] ..
To whom did you report? ..
11. Name & Address of your employer/School/College/Univ.
Tel No.
.
Position held: .
.
Work reference No:
.
Salary: .
.
Date start [month].. [year]
Reason for leaving ..
Date finished [month] .. .[year] ..
To whom did you report? ..
12. Name & Address of your employer/School/College/Univ.
Tel No.
.
Position held: .
.
Work reference No:
.
Salary: .
.
Date start [month].. [year]
Reason for leaving ..
Date finished [month] .. .[year] ..
To whom did you report? ..
13. Name & Address of your employer/School/College/Univ.
Tel No.
.
Position held: .
.
Work reference No:
.
Salary: .
.
Date start [month].. [year]
Reason for leaving ..
Date finished [month] .. .[year] ..
To whom did you report? ..
14. Name & Address of your employer/School/College/Univ.
Tel No.
.
Position held: .
.
Work reference No:
.
Salary: .
.
Date start [month].. [year]
Reason for leaving ..
Date finished [month] .. .[year] ..
To whom did you report? ..

Declaration:
You must read and sign the following statement, if applicable for employment is to be progressed.
The information I have given is true and correct to the best of my knowledge and belief. I understand that any false statement or
omission will render myself liable to instant dismissal, without notice or payment in lieu. I also understand that, to dishonestly obtain a
pecuniary advantage, is a criminal offence under the Theft Act, 1968 s.16
I hereby, authorize Urgent Security Services ltd , to obtain from any Government Agency, former employers and personal referees
verbal and written confirmation of my work history and character.

Name: Signature: .. Date:

EMPLOYEE RECORD
Name [Print Full Name]:

Tel No.

Address: .......................

Post Code:

Interview Date:

Provisional Offer Date:

Interview by[print name]:

PIN No:

[ Photograph ]

Acceptance Date:
Signature:

Enter on NR[date]:

Payroll informed[date]:

Position:

Responsible to:

Starting date:

Hourly rate: Salary:

Fortnightly : Monthly

Provisional offer [date]:

APPOINTMENT:

DOCUMENT CHECK LIST:

The originals of the following documents must be seen, copies taken and endorsed [certified copy]
Birth certificate:[original]

Copy taken and endorsed:

In file:

Passport: [original]

Copy taken and endorsed:

In file:

Driving license: [original]

Copy taken and endorsed:

In file:

Service record book : [original]

Copy taken and endorsed:

In file:

Utility bill: [original]

Copy taken and endorsed:

In file:

P45 / 46: [original]

Self-employed declaration:

In file:

PHYSICAL ASSESMENT:
The applicant must be tested for all of the following, prior to a provisional offer of employment:
Height:
Sight:
Colour perception:
Hearing:
Smell:
Report writing:
Language skill:[the applicant must be able to carry out an arrest procedure, using appropriate language and be understood]
The applicant has been tested according to BS 7499 and appear to be fit for the duties assigned and all employees who are required to
work Night Shifts have been offered the opportunity to have a free medical
Name: . Signature:... Date:.
DOCUMENTS ISSUED:
Main Terms & Conditions of Service:
Health & safety policy:
Disciplinary Procedures:
Time sheets:
Standing orders:
Contract of employment:
I.D Card:

TRAINING NEEDS ASSESSMENT:

Induction:
Manned guarding:
Retail:
Other[specify]
Date planned:
Date received:
Please read and sign the following statement:
All of the above has been explained and I agree with the stated physical assessment that I am fit to carry out duties assigned to myself
and I have been offered the opportunity to have a free medical, if I am required to work Night Shifts. I have been issued with the
document indicated.
[Print Full Name]Signature.Date.

EMPLOYEE RECORD
UNIFORM REQUISITION:

Security Officer[print name]:

Date issued:

Issued by:
Quantity

Size

SHIRTS
JUMPER
TROUSERS
TIE
EPAULETS
BLAZER
JACKET
SAFTY FOOTWARE
HI-VIZ JACKET
HARD HAT
Received by[print name]:

Signature:

Comments

Date:

WORKING TIME REGULATIONS:

Please read and sign the following statement:
The Working Time Regulations have been explained to me. I understand that the Security Industry has been exempted from the 48
hour week. I agree to waive my right, and understand that I could be allocated duties in excess 48 hours per week. I also understand
that I may be required to work shift patterns, weekends and some Bank Holidays. However I will be required to take appropriate
Compensatory Rest Period.
It has been explained to me, that I may relinquish this agreement by giving Urgent Security Services ltd., not less than fourteen days
notice. Should I do so, I understand that I may be offered, and required to take, re-deployment to an alternative site so as not to disrupt
the working harmonization of other personal.
[Name]. [Signature]..[Date]...
CRIMINAL CONVICTIONS,CAUTIONS,CIVIL PROCEEDINGS, BANKRUPTCY & MOTORING OFFENCES:
Please read and sign the following statement:
It has been explained to myself that I must report all and any Police cautions, arrests, criminal convictions, civil proceedings,
bankruptcy, or motoring offences that have occurred prior to being offered provisional employment by Urgent Security Services ltd . It
has also been explained to myself that during my employment with Urgent Security Services ltd, should any of the afore mentioned
situations occur, I must report them as soon as is practicable to the Security Manager for Urgent Security Services ltd.
[Failure to do so will result in instant dismissal without notice or payment in lieu. The actuality of any offence will require full
investigation and in some circumstances may require you to resign your employment].
[Name]. [Signature]..[Date]...

For office use only:

Notes:--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

INTERVIEW ASSESMENT FORM

Personal details:

Date:

Surname:

First Names:

Male/Female:

Can the applicant demonstrate:

Good general health?
Good eyesight (including color vision)
Hearing and
Sense of smell?
Are they also able to demonstrate:
Good reading ability?
Writing ability?
Verbal communication ability?
Are they able to demonstrate they will be able to maintain agreed standards of appearance and
deportment whilst at work?
Are person recruit for security duties aged at least 18 years?
Can the applicant confirm that written confirmation can be obtained for the whole of the
screening period on a month to month basis?
Can the applicant provide two character references, confirming the period and nature of the
relationship and wherever practicable includes the most recent employer?
Has the applicant had any cautions, convictions and/or pending prosecutions?
Has the applicant any bankruptcy proceedings and outstanding judgments for debt?
Does the applicant understand tat misrepresentation/failure may lead to dismissal/legal action?
Does the applicant understand that assistance in obtaining written evidence in confirmation of
their suitability is required?
Are the following confirmed, in writing:
(a) current place of residence
(b) Date of birth : British certificate, Passport, Military papers
If you make a photocopy of original documents do you endorse and sign the copy as
authentication?
Does the applicant understand that employment will not to commence until satisfactory
completion of 5 year screening period?
And that employment is provisional and subject to time limitation of:
16 week time limit?
Character?
Appearance?
Attitude?
State the reason for applying for the position?

INTERVIEW ASSESMENT FORM

Interviewers Comments: (comments must be made)
-----------------------------------------------------------------------------------------------------------------------------------------------------------------

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------If unsuccessful the interviewer must give full reasons:

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Successful: YES :

NO

Interviewer [print name]:

Signature:

10