Application for EmploymentDRIVER

Please answer all questions in fullApplications which are not completed in full will not be processed

Note: All fields / sections marked with an asterisk (*) are mandatory

PERSONAL INFORMATION

Title* Surname* Forename(s) / Given name(s)*

Previous name(s)

N.I. NumberAddress Line 1*

Address Line 2

Town*

County*

Postcode*

E-mail Address*

Home Telephone Number

Mobile Telephone Number

Work Telephone Number (if contactable)

For office use only

Application number:

Date received:

Application form checked by:

Signature Date

Suitable for interview: If 'No', reason:Yes No

Interview arranged:

Date: Time:

Written test Highway code test Driving assessment

Yes NoAre you eligible to work in the UK? *(please indicate review date if this is not indefinite)

Have you ever applied for employment with, or worked for Sullivan Buses? Yes No

Position applied for

This form must be completed, then sent electronically to admin@sullivanbuses.comPrinted versions of this form should be posted to 6 Deards House, St Albans Road, South Mimms, Potters Bar, Hertfordshire, EN6 3NE

Applicant No.

Date: / /

Page 3 of 12

DRIVER LICENSE INFORMATION

Do you hold:

Other, please specify

Licence type: UK / EEC International

How long have you been driving continuously in the UKon a full valid licence?

Yes NoA current driving licence?

Expiry date

Driver number

Date passed test

Are there any endorsements on your licence?

Date of offence Convictions Penalty or No. of points Conviction code (eg SP30)

Yes NoAre you subject to any pending motoring offences?

Date of offence

If 'YES' please provide details...

Notice of offence

Have you ever been disqualified or banned from driving? If 'YES', on what grounds...Yes No

Yes NoHave you ever been refused a licence or entitlement?

If 'Yes' :

Yes NoUK PCV Entitlement?

Expiry dateDate passed test

If 'Yes' :

Yes NoProvisional PCV Entitlement?

Expiry dateDate passed test

If 'Yes' :

If you are a PCV licence holder, please provide details ofwhere PCV training was undertaken:

Yes NoA driver’s certificate of Professional Competence?

Partial

If 'Partial', please provide details of where trainingwas undertaken:

Course Reference

Yes No If 'YES' please provide details...

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)

CONVICTIONS AND LEGAL PROCEEDINGSWith the exception of offences which are “spent” under the terms of the “Rehabilitation of Offenders Act 1974”, enter theexact 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 falseparticulars you will not be considered for employment or, if already engaged, you will be liable to instant dismissal. If youhave no convictions or outstanding summonses write “none”. We have a contractual requirement with some localauthorities 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 thecommencement of employment. If short listed, applicants may therefore be asked to complete a disclosure form. Fullguidance notes will be issued. Any information disclosed will be kept in strictest confidence and will only be used whenconsidering your suitability for the post that you have applied for. The CRB have produced a Code of Practice, whichwe have to adhere to. Should you wish to view the Code it is available on the CRB website, or alternatively, a copy can bemade available to you upon request. A criminal record will not necessarily prevent you obtaining the position.

Date of offence Nature of offenceDate of conviction Sentence or Court Order

Yes NoWould you object to a background check to ascertain "unspent convictions"?

GENERAL EDUCATION AND TRAININGPlease 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 DETAILSPlease include details of present or most recent employment and all employment over the last seven years, as well asall previous PCV operation employment. Include any periods of voluntary work, caring, homemaking or unemployment inthis section, including work abroad, with dates. References will be sought from previous employers.

CURRENT OR MOST RECENT (STATE FULL ADDRESS AND POSTCODE)

Employer name

Employer address

Name and title of supervisor

Job title of position held

Duties

Date started Date finished

Reason for leavingSalary

PREVIOUS EMPLOYMENT (1) (STATE FULL ADDRESS AND POSTCODE)

If you have had more than five employers in the last seven years, please provide further details in the "FurtherInformation" box later in this form.

Employer name

Employer address

Name and title of supervisor

Job title of position held

Duties

Date started Date finished

Reason for leavingSalary

Employer address

Name and title of supervisor

Duties

Date started Date finished

Reason for leavingSalary

PREVIOUS EMPLOYMENT (2) (STATE FULL ADDRESS AND POSTCODE)

Employer name Job title of position held

PREVIOUS EMPLOYMENT (3) (STATE FULL ADDRESS AND POSTCODE)

Employer name

Employer address

Name and title of supervisor

Job title of position held

Duties

Date started Date finished

Reason for leavingSalary

Employer address

Name and title of supervisor

Duties

Date started Date finished

Reason for leavingSalary

PREVIOUS EMPLOYMENT (4) (STATE FULL ADDRESS AND POSTCODE)

Employer name Job title of position held

PREVIOUS EMPLOYMENT (5) (STATE FULL ADDRESS AND POSTCODE)

Employer name

Employer address

Name and title of supervisor

Job title of position held

Duties

Date started Date finished

Reason for leavingSalary

What length of notice will you be required to give to your present employer?

On what date could you begin employment with Sullivan Buses?

VOCATIONAL QUALIFICATIONS & OTHER SKILLS

Please use this space for additional information and/or outline the reasons you would like to work for us. You shouldalso use this space to give any relevant information, which may have a bearing on your suitability to be a PCV driver. Youmay 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.

FURTHER INFORMATION

How did you hear about this vacancy?

Please give details of any other skills/quali�cations (for example, Driver’s CPC or how many hours have been completed towards Driver CPC

REFERENCESWE WILL REQUEST REFERENCES FROM PREVIOUS EMPLOYERS. HOWEVER, IF YOU HAVE BEEN SELF-EMPLOYED, PLEASE GIVE DETAILS OF YOUR ACCOUNTANT(S) IN THE SPACE(S) PROVIDED BELOW.

Name of accountant

Address

Title / position

Company name

Telephone number

Name of accountant

Address

Title / position

Company name

Telephone number

At this stage, do we have permission to contact your referees?

If 'NO', please indicate when it would be acceptable (e.g. on provisional offer of job)

Yes No

INFORMATIONThe 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 submitthis entire form to Sullivan Buses.

SECTION AName

Age Height ft in m cm

Weight st lb kg

Imperial Metric

ORPlease choose imperialor metric measurements

SECTION BHave you ever in your life, including childhood, had any of the following?

Any heart conditionYes No

Loss of sight or cataract removed

Double or tunnel vision

Any epileptic attack, stroke or loss of consciousness

Drink problem

Drug addiction

SECTION CAre you being treated for any of the following?

AnginaYes No

Medical or nervous disorders

Diabetes with insulin injections

SECTION D

Have you stayed away from work or school in the past year?Yes No

Have you consulted a doctor in the past year?

Have you any permanent disability?

SECTION EIf you have answered YES in any of the boxes or if you have any other medical conditions whichmay affect your ability to work, please give particulars:

SECTION FIf you have any other medical condition not listed above which may affect your ability to work ordrive a bus (eg. hearing or eyesight impairment), please give particulars:

SECTION G

MEDICAL INFORMATION

DateYour e-mail address (previously entered)

Diversity Monitoringto be completed by all job applicants

Our vision is to be recognised as the leading transportservices organisation the UK. To support that vision, weare committed to delivering a better service and believe thata diverse workforce that more closely reflects our customerbase will create opportunities for all of us to share in oursuccess.The aim of our policy is to ensure that no job applicant oremployee receives less favourable treatment on grounds ofrace, colour, creed, nationality, ethnic or national origin,religious belief, political opinion or affiliation, sex, age, maritalstatus, sexual orientation or disability, or is disadvantaged byconditions or requirements which cannot be shown to bejustifiable.Our selection criteria and procedures are frequentlyreviewed to ensure that individuals are selected, promotedand treated on the basis of their relevant merits and abilities.All employees are encouraged and given opportunities toprogress within the organisation.To ensure that this policy is fully and fairly implemented andmonitored and for no other reason, would you please providethe following information:Choosing not to complete this form will in no way affect yourapplication.

Name

Postcode Date

Location of job applied forDo you already work for Sullivan Buses? Yes No

Ethnic OriginsWhich best describes your ethnic origin?

British

WhiteEnglish Scottish Welsh

Irish European

Other White, please state

White/Black Caribbean

MixedWhite/Black African

White Asian

Other Mixed, please state

Indian

AsianPakistani Bangladeshi

Other Asian, please state

Caribbean

BlackAfrican

Other Black, please state

RecruitmentWhere did you learn about this job vacancy?please tick appropriate box/es

Newspaper, Local

Trade Journal

Bus Advertising

Bus Ticket Advertising

Leaflet Drop

Internal Notice

Newspaper, National

Jobs Publication

Word of Mouth

Internet Site

Job Fair

Cold Call

Job centre

other, please state

Are you eligible to work in the UK?Yes No Not Sure

Which gender are you?Male Female

Date of Birth

Which age range applies to you?16 - 20 21 - 30 31 - 40

51 - 55 56 - 60 61 - 65

Please let us know if there are any special arrangements orfacilities we can provide, that you think you would need toattend the assessment day / interview or to take up the post.

Which job are you applying for? (previously entered)

FOR INTERNAL USE ONLY

Chinese

Chinese

Any other backgroundPlease state

41 - 50

66+

Job Category

Manager Recruiting

Job Locations

02/03

Your e-mail address (previously entered)

DECLARATION AND VALIDITY

I declare that the information provided on this application form is , to myknowledge true and accurate. I understand that if it is subsequently discoveredthat any statement is false or misleading, I may be discharged from employmentwith Sullivan Buses. With the exception of offences, which are “spent” under the terms ofthe “Rehabilitation of Offenders Act 1974”, I have included details of criminal orcourt martial convictions including driving convictions. I understand that it maybe necessary, at some locations, to undergo a Criminal Records Bureau check,which will ask exempted questions under the “Rehabilitation of Offenders Act1974” and will show offences that are “spent” under the Act. I agree to a pre-employment medical examination, eyesight and drugs testing in line withprocedure, and acknowledge that if I fail either of these tests my employment willbe terminated. I am legally entitled to take paid employment in the UnitedKingdom. I consent to Sullivan Buses seeking references from previous employers.

Tick 'YES' box to accept declaration

Date NameYes No

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