Registration Form Registration Form Vacancy TitleFirst NameLast NameAddressAddress Line 1CityCountyPost CodeDate of BirthTelephone NumberNationalityNational Insurance #EmailBank DetailsAccount NameBank NameAccount NumberSort CodeEmployee StatementPlease select the right statement A – THIS IS MY FIRST JOB SINCE LAST 6 APRIL AND I HAVE NOT RECEIVED ANY TAXABLE ALLOWANCES, BENEFITS OR PENSIONS B – THIS IS NOW MY ONLY JOB BUT SINCE LAST 6 APRIL I HAVE HAD ANOTHER JOB, OR RECEIVED TAXABLE ALLOWANCES OR INCAPACITY BENEFIT. I DO NOT RECEIVE A STATE OR OCCUPATIONAL PENSION C – AS WELL AS MY NEW JOB, I HAVE ANOTHER JOB OR RECEIVE A STATE OR OCCUPATIONAL PENSION Student Loan to be Repaid Yes NoPlan Type 1 2PGL to be repaid Yes NoDo you hold a full, clean driving licence valid in the UK? Yes NoNext of Kin detailsNameTelephone NumberRelationshipConvictions/ DisqualificationsA criminal record will not necessarily be a bar to obtaining a position at Greenv. If a check is returned and reveals any information, this will be discussed with the applicant.Do you have any criminal conviction(s)? Yes NoPlease provide details below if you have been convicted of a criminal offence or been the subject of a conditional discharge or probation order. Reasonable Adjustments/Arrangements for interviewPlease contact us if you need the application form in an alternative format including large print.Are you subject to any conditions relating to your employment in this country? Yes NoPlease use the space below to tell us what these areIf you need us to make any adaptations for your interview to accommodate any disability you may have please tell us what these should be?If appointed when could you start? Give period of notice if applicableReferencesPlease give the detail of two references – see guidance sheet for further information.Name of referee and relationship to you:EmailTelephone NumberName of referee and relationship to you:EmailTelephone NumberPermission to contact your previous employers for reference: Yes NoReferences We will take up professional references once you have been interviewed and provisionally offered the post. Please make sure that you have given the full contact details of your referees so that this does not delay processing reference requests. If you have no employer references, we will take up references with named individuals at colleges where you have studied, or people who know you in a professional capacity. Please do not put down family members or people you live with as referees.Right to WorkPlease upload proof of your Right to Work within the UKProof of Right to Work documents / VISA / Share Code Passport VISA Share CodePassport Upload (JPG / PNG / PDF / DOC Allowed)Choose File VISA Upload (JPG / PNG / PDF / DOC Allowed)Choose File Share CodeDeclarationPlease complete the following declaration and sign it in the appropriate place below I agree that Greenv can create and maintain computer and paper records of my personal data and that this will be processed and stored in accordance with the Data Protection Act 1998. I confirm that all the information given by me on this form is correct and accurate and I understand that if any of the information I have provided is later found to be false or misleading, any offer of employment may be withdrawn or employment terminated.Submit Form
