I accept each of the above statements
SIA Badge Number
What role are you applying for?
How did you hear about this vacancy?
Surname (include all aliases)
Maiden / Former Names
Date of Birth
Place of Birth
Country of Birth
---AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d’IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor-Leste)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonThe GambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesia, Federated States ofMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe
May we use this email address to send important information? (e.g. staff rotas)
Home Telephone Number
Mobile Telephone Number
National Insurance Number
What type of accomodation is it?
---OwnerRenterLiving with parentsLodging
Work Telephone Number
Please complete the following providing full details.
Have you or any of your immediate family ever been convicted, fined, imprisoned, placed on probation, discharged on payment of costs of had any order made against you by a criminal, civil or military court or public authority (excluding minor motoring offences)?
Do you have any Police Cautions?
Are any prosecutions pending against you?
Have you ever been subject to bankruptcy proceedings?
Do you own a motor vehicle or motor cycle?
Do you possess a full, clean, current UK Driving Licence?
Driving Licence Number:
Give details of any endorsements (If any) or other motoring convictions during the last five years:
Name of last school / college attended:
Address of last school / college attended:
First Aid / Fire Fighting Certificates:
Exams taken and qualifications gained:
Starting with your last or present employer, give details of your employment history, with FULL POSTAL ADDRESS, for the last five years or since you left full time education. Include periods of self-employment and military service. Please state any periods of unemployment that you did not register with the department of unemployment as “not registered/unemployed” and give full details of what you were doing. If self employed you must give name, address and telephone number of your accountant.
I agree that Leisure Guard Security may approach my employer(s) to confirm the information given in this form
Basic wage (per year)
Reason for leaving
Account Holder's Name
Sort CodeE.G. 12-34-56
Account NumberE.G. 12345678
Role NumberApplicable only to Building Society Accounts