Fleet Plus Recruitment

Personal Details * Denotes required field
All applicants must be at least 23 years old. Are you 23 Years or over?

* Driving Licence Check Code: (From Step 1)		Get your Code Here

Please select one reason for completing this form:
New employee/driver assessment
Current employee/driver re-assessment or change in medical/health condition

* Title:
* Forename:
* Surname:
* Date of Birth:		* National Insurance Number:

* Address:		* Home Tel: Evening Tel: Mobile Tel:
*Postcode		Email Address:
Job Title?

Location?

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Previous Employment History dating back 5 Years
(Including all breaks of non-employment. Most recent first)

Position:	Job Title:
Employer and Address:	Employment Dates: (Month & Year)	From to
Salary and Benefits:
Main Duties and Responsibilities:	Reason for Leaving:
Notice Period: (Type N/A if Not Applicable)

Job Title:
Employer:	Employment Dates: (Month & Year)	From to
Salary:
Main Duties:	Reason for Leaving:

Job Title:
Employer and Address:	Employment Dates: (Month & Year)	From to
Salary:
Main Duties:	Reason for Leaving:

Job Title:
Employer and Address:	Employment Dates: (Month & Year)	From to
Salary:
Main Duties:	Reason for Leaving:

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Education
Secondary education:	Dates Attended: (Month & Year)	From to
Qualifications/grade:

Higher education:	Dates Attended: (Month & Year)	From to
Qualifications (with date)/grade:

Other relevant training, professional qualifications or work-related skills (for example languages, driving qualifications, etc):

Are you undertaking any course of study at present? (if so, please give details):

Do you have membership of any professional bodies? (if so, please give details, including any offices held):

Supporting information - Please give any details you feel are relevant in support of your application, including why you are interested in this post. Please explain any gaps in your employment history.


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Other Details Check the box for Yes, leave blank for No
Is your present post your sole regular employment?
Are you a British subject?
If not, please provide your right to work in the UK government share code:
Do you have a full driving licence?
Do you have any current endorsements?
please provide details of the endorsements
Do you have use of a car?
Where did you see the advertisement for this post?
Do you know anyone who currently works for IT Fleet?
Please provide details:
Disabilities
Do you require any special arrangements to be made for your interview/assessment test because of a disability?
If 'yes', please give brief details of the effects of your disability on your day-to-day activities, and any other information that you feel would help us to accommodate your needs during your interview/assessment test and thus meet our obligations under the Equality Act 2010:

Convictions
Have you ever been convicted of a criminal offence?
If 'yes' please give details of any unspent convictions. Spent convictions do not have to be declared as the job is not one covered by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975:
Searches
As part of our recruitment process, we undergo internet searches regarding the applicant before offering any work with IT Fleet. We undertake these checks in line with our recruitment policy and privacy notice (more information can be provided on request). If, in the case of information being found as a result of a search this information will be made available and the applicant will have the right to respond. This information is completed in order to screen our candidates effectively to undertake work on behalf of our customers and IT Fleet Automotive

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Medical questionnaire : Medical in Confidence
Please answer the questions below.	Yes/No
Do you have any difficulties reading a number plate at 20m with or without spectacles? You must check this before you answer.
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
Do you wear spectacles for distance vision?
Please indicate when you these were issued and the date of your last eye test. If it has been more than 2 years since your last eye test, please arrange an appointment with your Optician before completing this form.
Are you without sight in either eye?
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
Do you have double vision?
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
Do you have any eye problems which cannot be corrected by spectacles or contact lenses?
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
Do you have a physical disability affecting your arms, legs, neck or back?
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
Have you ever had any fit or seizure?
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
Do you suffer from Epilepsy?
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
Have you ever been unconscious for any reason or suffered prolonged or repeated dizziness or vertigo?
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
Do you have any problems hearing a normal conversational voice (with or without a hearing aid)?
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
Do you have Diabetes?
Please give full details of type and treatment.
Do you or have you ever had?
A heart attack
Angina
Palpitations
Heart Failure
Raised blood pressure
Any investigations/operations on your heart or blood vessels
No to all the above
Attention If you are taking medication for blood pressure or heart problems, you must provide evidence of the last 3 blood pressure readings, taken by your GP, signed on headed paper or compliments slip. This is a DVLA requirement. Without this, we are unable to process your application.

Have you ever suffered from any form of mental health problems?
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
Have you ever been dependent on alcohol, drugs or other substances?
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
Do you now or have you ever suffered from any brain or neurological problems e.g. stroke, brain haemorrhage, multiple sclerosis or brain surgery?
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
Do you take any medication?
Please give list all medication
Do you have, or have you had any health problems not included in the previous questions?
Please give full details/dates, e.g. treatment/medication or if you have fully recovered
How often will you be driving?
Is your medical condition reportable to the DVLA? You must check this by following the link: https://www.gov.uk/health-conditions-and-driving
If you have answered Yes to the above, please provide a copy of the letter from the DVLA as to the outcome of your medical investigation and fitness to drive. If you have lost your letter, you can obtain a copy by contacting DVLA directly.
Will you be carrying passengers?
Please provide details

* Signed:	* Date:
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Drivers Supplement
*Driving Licence Number:
*Date Driving Licence Obtained:
Have you held a full UK Driving License for 2 years or more?	Yes:

Do you have more than 6 penalty points on your licence?	Yes:
Have you ever been banned from driving? If the answer is Yes please state reasons below:	Yes:


Do you have off road parking? IT Fleet Automotive cannot insure vehicles parked on a public highway overnight, therefore you must have access to off-road parking for IT Fleet Automotive to be able to offer you work. This must be a private driveway, garage or an off-road allocated parking space large enough to fit a sprinter van (2m wide x 7m long). Failure to utilise off-road parking may result in you being held liable of any damage caused to the vehicle in your possession.	Yes:
Experience Have you driven any of the following vehicles?
Two Tonne Tipper:	Yes:
Transit van (short and long wheel base):	Yes:
7.5 Tonne:	Yes:
Minibus (up to 17 seats):	Yes:
Luton box van:	Yes:
If the answer is no, are you prepared to drive all of the above as long as your license allows you to?	Yes:
Have you driven automatic and manual vehicles?	Yes:
Do you have any enhancements to your license?	Yes:
Please provide details of the Enhancements?

Uniform You will be required to wear IT Fleet Automotive uniform when undertaking work on our behalf. You would be issued with a jacket, 3 x shirts and a high visibility tabard. You will be required to supply and wear your own navy/black trousers and sensible shoes (black/navy). No jeans or trainers. Please provide your sizes below:
Shirt Collar Size (between 14.5" – 23")
Jacket size (S, M, L, XL, 2XL, 3XL)
Female uniform (between 6 - 24)

I acknowledge that all the information provided is correct. I understand that any misleading/incorrect statements may result in withdrawal of any employment offer or cancellation of any agreement.
* Signed:	* Date:
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Attention