Job Application QRS Facilities Ltd Security Application Form 1.Personal Information Title * — Select — Mr Mrs Miss Ms. Dr. Prof. Other Name * First Middle Last Date Of Birth * DD/MM/YYY Email Address * Picture * Passport size picture Marital status * — Select — Married Single other Contact Number * UK Valid Number With active WhatsApp Gender * — Select — Male Female Prefer not to say Current Address * if you have lived at your current address less than 3 years, provide your previous address. Post Code * Previous Address * Image Upload * Select Image Any utility bill or Bank Statement No more then 3 month old Image Upload * Select Image Any utility bill or Bank Statement No more then 3 month old Driving License * — Select — Yes No IF yes Answer next Question You Have Vehicle — Select — yes no Health * Do you have issues with your vision hearing or general mobility or any other health issue? if yes Please provide details. If you require any special adjustments please state. Next of Kin * Provide details of your next of kin Name relationship address Telephone (For emergency Contact) Education: Type of Institute Grades Name of Institute Address of Institute From TO Equal Opportunities: * — Select — British African Asian Caribbean Chinese White Other This section is voluntary and will NOT be used in assessing your application. QRS Facilities Ltd is an equal opportunities employer. If you decide to complete this section, it will help us to monitor the effectiveness of our Equal Opportunities Policy. Please tick the appropriate box below If other, please specify 2. Supporting documents Right to Work in Uk * Yes BRP / Uk Passport Number OR Other Valid Document * Expiry Date * Right to work UK Passport, BRP or Share code * Select Image How to get Share code https://www.gov.uk/prove-right-to-work N I number * National Insurance Number DBS Enhanced Check * — Select — Yes No Please Provide DBS Enhanced Check Certificate (if you do not have this please apply for this before completing this application DBS certificate or share code Photo * Select Image How to get share code copy this link to your internet browser. https://www.gov.uk/guidance/track-a-dbs-application#:~:text=After%20logging%20in%2C%20select%20'Manage,can%20view%20the%20necessary%20certificate. Convictions * Yes (if yes please provide details in Other Information) No Are there any Convictions outstanding against you? Yes No (please circle) If yes, please provide details: Have you ever been convicted of any civil or criminal offences? 3. Position Applying For Position * — Select — Security Door Supervioser CCTV Steward License Number * If you applying for stewards please (N/A) Expiry Date * Front side of License * Front side of licence Back side of License * Back side of license Fist Aid course * — Select — yes no Please provide certificate Certificate Photo * Certificate Photo Any other License or training Certificate * — Select — yes No if yes please provide information in other section 4. Work Experience Reference Work Experience * — Select — Yes No if yes please provide information for reference Company Name Contact Number Name to Contact Email Address Payment Bank Name Sort Code Name on Bank Statement Account Number Payments will be made between 15th to 20th of each month 5.Company Policies Confirm Shifts * If you will not go to your Confirmed Shift you MUST pay a penalty charge. You have to provide us with minimum 8hrs notice if you are not able to Cover your Confirmed Shift. Time Clock * You must be on site (10 minutes) before Shift Start. If you are late for more than (5 minutes) 30 mins of your shift will be deducted OR you may be sent back from the site. Uniform * Black Shoes, Black Jacket/Blazer, White Shirt/Blouse, Black Tie, Hi-Viz, (No Logo) Black Trouser If you DO NOT follow the Uniform Standards you must pay a penalty charge of £50. You may be sent back from the Site. General Data Protection Regulations (GDPR) * - QRS Facilities Ltd will use the information you have given on your application form (together with any information which we obtain with your consent from third parties) for assessing your suitability for employment. It may be necessary to disclose your information to our agents and other service providers. By returning this form to QRS Facilities Ltd you consent to our processing personal data about you where this is necessary, for example information about your credit status, ethnic origin or criminal offences. You also consent to the transfer of your information to your current and future potential employers where this is necessary (this may be to companies operating abroad if you apply for work outside of the United Kingdom). Your information will be held on our computer database and/or in our paper filing systems. By signing below, you agree to this process and confirm that you do not have a criminal record subject to the current Rehabilitation of Offenders Act and any amendments. You have the right to apply for a copy of your information and to have any inaccuracies corrected SCREENING * Any offer of employment is subject to satisfactory screening, that the applicant consents to being screened in accordance with BS7858 and will provide information as required. That the information provided is correct, and the applicant acknowledges that any false statements or omissions could lead to termination of employment 6. Declaration Declaration * I certify that to the best of my knowledge, the information that I have given in my application for employment is true and complete and understand that any false statement or omission to QRS Facilities Ltd or its representatives may render lead to termination of employment without notice. I confirm that the information I have provided on my application is true and complete to the best of my knowledge. I Understand and agree that I will be subject to any or all of the following checks: Address check, Financial Probity check which company will retain on file, Id verification check, Academic / Professional qualification check, Employment history, including any periods of unemployment/self-employment and any gaps, Criminal background check. 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 in confirmation of previous employment or unemployment. I authorise QRS Facilities Ltd or its nominated agents to carry out financial history check /credit check and approach Government agencies, former employers, educational establishments, for information relating to and verification of my employment/unemployment record. I authorize QRS Facilities Ltd to make a consumer information search and ID checks with a credit reference agency, which will keep a record of that search and may share that information with other credit reference agencies. I consent to QRS Facilities Ltd reasonable processing of any 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 QRS Facilities Ltd Subject to the Access to Medical Reports Act 1988, I consent to the results of such examinations to be given to QRS Facilities Ltd. I further declare that any documents that I provide as proof of my identity, proof of address, proof of right to work and any other documents that I provide are genuine and give my consent for these documents to be examined under a UV scanner or similar device. I acknowledge that any falsified documents may be reported to the appropriate authority. I understand that it may be a criminal offence to attempt to obtain employment by deception and that any misrepresentation, omission of a material fact or deception will be cause for immediate withdrawal of any offer of employment I confirm that my consent is explicit, fully informed and freely given for the purposes of this job. print name or signature Date / Time * Other Information