Applicant No.
Application for Employment
DRIVER
Please answer all questions in full
Applications which are not completed in full will not be processed
Note: All fields / sections marked with an asterisk (*) are mandatory
This form must be completed, then sent electronically to admin@sullivanbuses.com
Printed versions of this form should be posted to 6 Deards House, St Albans Road, South Mimms, Potters Bar, Hertfordshire, EN6 3NE
Date:
Position applied for
Have you ever applied for employment with, or worked for Sullivan Buses?
Yes
No
PERSONAL INFORMATION
Title*
Surname*
Forename(s) / Given name(s)*
Previous name(s)
Are you eligible to work in the UK? *
Yes
(please indicate review date if this is not indefinite)
N.I. Number
Address Line 1*
Address Line 2
E-mail Address*
Town*
Home Telephone Number
County*
Mobile Telephone Number
Postcode*
Work Telephone Number
For office use only
Suitable for interview:
(if contactable)
Yes
If 'No', reason:
No
Application number:
Interview arranged:
Date received:
Date:
Application form checked by:
Signature
Date
Written test
Time:
Highway code test
Driving assessment
No
DRIVER LICENSE INFORMATION
UK PCV Entitlement?
Do you hold:
A current driving licence?
Yes
No
No
If 'Yes' :
If 'Yes' :
Expiry date
Date passed test
Expiry date
Date passed test
Provisional PCV Entitlement?
Yes
No
If 'Yes' :
Driver number
Expiry date
Date passed test
Licence type:
Yes
UK / EEC
If you are a PCV licence holder, please provide details of
where PCV training was undertaken:
International
Other, please specify
How long have you been driving continuously in the UK
on a full valid licence?
A drivers certificate of Professional Competence?
Yes
Partial
No
If 'Partial', please provide details of where training
was undertaken:
Course Reference
Are there any endorsements on your licence?
Date of offence
Yes
Convictions
No
If 'YES' please provide details...
Penalty or No. of points
Are you subject to any pending motoring offences?
Conviction code (eg SP30)
Yes
No If 'YES' please provide details...
Have you ever been refused a licence or entitlement?
Yes
Have you ever been disqualified or banned from driving?
Yes
No
No If 'YES', on what grounds...
Date of offence
Notice of offence
Please give details of any road accidents, blameworthy or otherwise, in which you have been involved in the last five years (include dates and details)
Page 3 of 12
CONVICTIONS AND LEGAL PROCEEDINGS
With the exception of offences which are spent under the terms of the Rehabilitation of Offenders Act 1974, enter the
exact details of any criminal or court martial convictions. Please enter details of any outstanding Summons or Prosecution.
before answering the question you should note that if you have failed to give relevant particulars or should you give false
particulars you will not be considered for employment or, if already engaged, you will be liable to instant dismissal. If you
have no convictions or outstanding summonses write none. We have a contractual requirement with some local
authorities to operate school services on their behalf which are exempt from the Rehabilitation of Offenders Act 1974
(ROA). As a result, a Criminal Records Bureau (CRB) check will be undertaken in these locations prior to the
commencement of employment. If short listed, applicants may therefore be asked to complete a disclosure form. Full
guidance notes will be issued. Any information disclosed will be kept in strictest confidence and will only be used when
considering your suitability for the post that you have applied for. The CRB have produced a Code of Practice, which
we have to adhere to. Should you wish to view the Code it is available on the CRB website, or alternatively, a copy can be
made available to you upon request. A criminal record will not necessarily prevent you obtaining the position.
Date of offence
Date of conviction
Nature of offence
Sentence or Court Order
Would you object to a background check to ascertain "unspent convictions"?
Yes
No
GENERAL EDUCATION AND TRAINING
Please include any full/part time courses, including apprenticeships, correspondence and vocational qualifications.
Subjects studied/course title
Qualification achieved
Grade
Course Date From
Course Date To
EMPLOYMENT DETAILS
Please include details of present or most recent employment and all employment over the last seven years, as well as
all previous PCV operation employment. Include any periods of voluntary work, caring, homemaking or unemployment in
this section, including work abroad, with dates. References will be sought from previous employers.
CURRENT OR MOST RECENT
(STATE FULL ADDRESS AND POSTCODE)
Employer name
Job title of position held
Employer address
Duties
Name and title of supervisor
Date started
Date finished
Salary
Reason for leaving
If you have had more than five employers in the last seven years, please provide further details in the "Further
Information" box later in this form.
PREVIOUS EMPLOYMENT (1)
(STATE FULL ADDRESS AND POSTCODE)
Employer name
Job title of position held
Employer address
Duties
Name and title of supervisor
Date started
Reason for leaving
Date finished
Salary
PREVIOUS EMPLOYMENT (2)
(STATE FULL ADDRESS AND POSTCODE)
Employer name
Job title of position held
Employer address
Duties
Name and title of supervisor
Date started
Salary
Reason for leaving
PREVIOUS EMPLOYMENT (3)
(STATE FULL ADDRESS AND POSTCODE)
Employer name
Job title of position held
Employer address
Duties
Name and title of supervisor
Date started
Reason for leaving
Date finished
Date finished
Salary
PREVIOUS EMPLOYMENT (4)
(STATE FULL ADDRESS AND POSTCODE)
Employer name
Job title of position held
Employer address
Duties
Name and title of supervisor
Date started
Salary
Reason for leaving
PREVIOUS EMPLOYMENT (5)
Date finished
(STATE FULL ADDRESS AND POSTCODE)
Employer name
Job title of position held
Employer address
Duties
Name and title of supervisor
Date started
Reason for leaving
What length of notice will you be required to give to your present employer?
On what date could you begin employment with Sullivan Buses?
Date finished
Salary
VOCATIONAL QUALIFICATIONS & OTHER SKILLS
Please give details of any other skills/qualifications (for example, Drivers CPC or how many hours have
been completed towards Driver CPC
FURTHER INFORMATION
Please use this space for additional information and/or outline the reasons you would like to work for us. You should
also use this space to give any relevant information, which may have a bearing on your suitability to be a PCV driver. You
may like to include details of any experience of dealing with members of the public, handling cash, hobbies and interests,
including memberships of clubs and societies and any personal achievements you are proud of.
How did you hear about this vacancy?
REFERENCES
WE WILL REQUEST REFERENCES FROM PREVIOUS EMPLOYERS. HOWEVER, IF YOU HAVE BEEN SELFEMPLOYED, PLEASE GIVE DETAILS OF YOUR ACCOUNTANT(S) IN THE SPACE(S) PROVIDED BELOW.
Name of accountant
Name of accountant
Title / position
Title / position
Company name
Company name
Address
Address
Telephone number
Telephone number
At this stage, do we have permission to contact your referees?
Yes
No
If 'NO', please indicate when it would be acceptable (e.g. on provisional offer of job)
INFORMATION
The following two pages are the Medical and Diversity forms.
The Medical form is mandatory, and the Diversity form is optional.
Finally, you will be required to accept and validate a legal declaration before being able to submit
this entire form to Sullivan Buses.
MEDICAL INFORMATION
SECTION A
Name
Age
Metric
Imperial
Please choose imperial
or metric measurements
Height
ft
in
Weight
st
lb
OR
cm
kg
SECTION B
Have you ever in your life, including childhood, had any of the following?
Yes
No
Any heart condition
Loss of sight or cataract removed
Double or tunnel vision
Any epileptic attack, stroke or loss of consciousness
Drink problem
Drug addiction
SECTION C
Are you being treated for any of the following?
Yes
No
Angina
Medical or nervous disorders
Diabetes with insulin injections
SECTION D
Yes
No
Have you stayed away from work or school in the past year?
Have you consulted a doctor in the past year?
Have you any permanent disability?
SECTION E
If you have answered YES in any of the boxes or if you have any other medical conditions which
may affect your ability to work, please give particulars:
SECTION F
If you have any other medical condition not listed above which may affect your ability to work or
drive a bus (eg. hearing or eyesight impairment), please give particulars:
SECTION G
Your e-mail address (previously entered)
Date
Diversity Monitoring
to be completed by all job applicants
Our vision is to be recognised as the leading transport
services organisation the UK. To support that vision, we
are committed to delivering a better service and believe that
a diverse workforce that more closely reflects our customer
base will create opportunities for all of us to share in our
success.
The aim of our policy is to ensure that no job applicant or
employee receives less favourable treatment on grounds of
race, colour, creed, nationality, ethnic or national origin,
religious belief, political opinion or affiliation, sex, age, marital
status, sexual orientation or disability, or is disadvantaged by
conditions or requirements which cannot be shown to be
justifiable.
Our selection criteria and procedures are frequently
reviewed to ensure that individuals are selected, promoted
and treated on the basis of their relevant merits and abilities.
All employees are encouraged and given opportunities to
progress within the organisation.
To ensure that this policy is fully and fairly implemented and
monitored and for no other reason, would you please provide
the following information:
Choosing not to complete this form will in no way affect your
application.
Name
Recruitment
Where did you learn about this job vacancy?
please tick appropriate box/es
Newspaper, Local
Newspaper, National
Trade Journal
Jobs Publication
Bus Advertising
Word of Mouth
Job centre
Internet Site
Bus Ticket Advertising
Job Fair
Leaflet Drop
Cold Call
Internal Notice
other, please state
Are you eligible to work in the UK?
Yes
No
Not Sure
Which gender are you?
Postcode
Date
Male
Location of job applied for
Do you already work for Sullivan Buses? Yes
No
Female
Date of Birth
Which age range applies to you?
Ethnic Origins
Which best describes your ethnic origin?
16 - 20
21 - 30
31 - 40
51 - 55
56 - 60
61 - 65
41 - 50
66+
White
British
Irish
English
Scottish
Welsh
European
Please let us know if there are any special arrangements or
facilities we can provide, that you think you would need to
attend the assessment day / interview or to take up the post.
Other White, please state
Mixed
White/Black Caribbean
White/Black African
White Asian
Which job are you applying for? (previously entered)
Other Mixed, please state
Asian
Indian
Pakistani
Bangladeshi
Your e-mail address (previously entered)
Other Asian, please state
Black
Caribbean
African
Other Black, please state
Chinese
Chinese
Any other background
Please state
FOR INTERNAL USE ONLY
Job Category
Manager Recruiting
Job Locations
02/03
DECLARATION AND VALIDITY
I declare that the information provided on this application form is , to my
knowledge true and accurate. I understand that if it is subsequently discovered
that any statement is false or misleading, I may be discharged from employment
with Sullivan Buses. With the exception of offences, which are spent under the terms of
the Rehabilitation of Offenders Act 1974, I have included details of criminal or
court martial convictions including driving convictions. I understand that it may
be necessary, at some locations, to undergo a Criminal Records Bureau check,
which will ask exempted questions under the Rehabilitation of Offenders Act
1974 and will show offences that are spent under the Act. I agree to a preemployment medical examination, eyesight and drugs testing in line with
procedure, and acknowledge that if I fail either of these tests my employment will
be terminated. I am legally entitled to take paid employment in the United
Kingdom. I consent to Sullivan Buses seeking references from previous employers.
Yes
No
Date
Name
Tick 'YES' box to accept declaration
THANK YOU FOR COMPLETING THIS APPLICATION. YOU ARE ASSURED THAT IT WILL BE TREATED IN THE STRICTEST CONFIDENCE
For office use only
Printed name of applicant
Signature of applicant
Date
