Position Applied for:

    Personal Details

    Date of birth

    (Please specify if born and raised in UK)

    If you are a foreigner applicant please provide your Sharecode
    if you are a British Citizenship holder, please fill up with "British Citizenship"

    Sharecode can be easily obtained from:

    Valid until

    Please fill up SIA related fields only if applicable, else leave them blank

    Valid until

    Emergency Contact Details

    Driving Details

    If yes, please provide a description of your offence/s below

    Criminal Convictions

    Have you, ever been fined, cautioned, sentenced to imprisonment or placed on probation for a criminal act (subject to the Rehabilitation of Offenders Act)?

    Are there any alleged offences outstanding against you?

    Have you, ever been made bankrupt or have any Court Judgements against you, whether satisfied or not, within the last 6years?

    Has any order been made against you by a Civil or Military Court or Public Authority?


    High School



    Banking Details

    This is where you will receive your payments if you are a successful applicant.

    Equal Opportunities

    5 Years Occupational Record

    IMPORTANT: if failed to provide 5 years history application will be discarded instantly

    State all periods of employment, unemployment and self-employment for the last 5 years or
    sinceleaving school. For any periods of unemployment, state the address of the Unemployment Benefit Office at which
    you reported (if applicable). This also includes employment status overseas.
    Start with present situation.

    Once you have provided 5 years tracking records you can leave the remaining statuses blank.
    If you did not work for a specific period just type "Unemployed" on Employer Name field, and specify from when to when on the timespan fields.

    Occupation 1

    Employer details



    Occupation 2

    Employer details



    Occupation 3

    Employer details



    Occupation 4

    Employer details



    Occupation 5

    Employer details



    Medical Questionnaire (Strictly Private and Confidential)

    Please complete the questionnaire below. the information is required with your interests in
    mind and will be retained in strict confidence. if further information is required from your
    medical practitioner, your written consent will be obtained beforehand. you may be referred
    to a doctor appointed by the company so that a medical examination can be carried out.

    Have you ever:

    1. had an operation?

    2. been seriously injured?

    3. received in-patient treatment for a physical or
    mental condition?

    4. been refused or dismissed from employment for
    health reasons?

    5. received a disability pension?

    6. had a disability?

    7. been made ill by your work?

    8. been refused a driver's license because of ill

    Do you suffer from or have you ever had:


    Skin Rashes/Eczema

    Swelling of Legs/Ankles

    High Blood Pressure


    Menstruation or Prostate Problems


    Headaches (Frequent)

    Varicose Veins

    Cough (Frequent)

    Heart Trouble


    Rheumatic Fever

    Chest Trouble

    Back Trouble


    Fainting or Dizziness

    Ear Trouble


    Hay Fever

    Eye Trouble

    Do you take medicine regularly?

    Have you worked in a dusty trade?

    Have you ever had a head injury?

    Do you suffer from any other ailments?

    Sign and Submit
    By signing and submitting this document, I can confirm that I understand and agree with the terms and conditions mentioned below.

    Please sign inside the box below


    I certify that to the best of my knowledge, the information that I have given in my application for employment is
    true and complete and understand that any false statement or omission to RMSS LTD or its representatives
    may render lead to termination of employment without notice.
    I understand and agree that if so required I will make a Statutory Declaration in accordance with the
    provisions of the Statutory Declarations Act 1835 in confirmation of previous employment or unemployment.
    I authorise RMSS LTD or its nominated agents to carry out financial history check /credit check and approach
    Government agencies, former employers, educational establishments, criminal justice agencies and personal
    referees for information relating to and verification of my employment/unemployment record.
    I consent to RMSS LTD reasonable processing of any personal information obtained for the purposes of
    establishing my medical condition and future fitness to perform my duties. I accept that I may be required to
    undergo a medical examination where requested by RMSS LTD Subject to the Access to Medical Reports Act
    1988, I consent to the results of such examinations to be given to RMSS LTD and authorize RMSS
    make a consumer information search with a credit reference agency, which will keep a record of that search
    and may share that information with other credit reference agencies.
    I further declare that any documents that I provide as proof of my identity, proof of address, proof of right to
    work and any other documents that I provide are genuine and give my consent for these documents to be
    examined under a UV scanner or similar device. I acknowledge that any falsified documents may be reported
    to the appropriate authority.


    Data Protection Act 2018 (GDPR)


    RMSS LTD will use the information you have given on your application form (together with any information
    which we obtain with your consent from third parties) for assessing your suitability for employment. It may be
    necessary to disclose your information to our agents and other service providers. By returning this form to
    RMSS LTD you consent to our processing personal data about you where this is necessary, for example
    information about your credit status, ethnic origin or criminal offences. You also consent to the transfer of your
    information to your current and future potential employers where this is necessary (this may be to companies
    operating abroad if you apply for work outside of the United Kingdom).
    Your information will be held on our computer database and/or in our paper filing systems. By signing below,
    you agree to this process and confirm that you do not have a criminal record subject to the current
    Rehabilitation of Offenders Act and any amendments. You have the right to apply for a copy of your
    information and to have any inaccuracies corrected.


    You are applying for a position of trust and in the event of being offered employment by RMSS LTD we may
    apply for a Disclosure. However, having a criminal record does not necessarily bar you from employment. For
    more information, ask a member of staff for a copy of the CRB Code of Practice/Disclosure Scotland and/or
    Company our policy statement regarding ex-offenders. Disclosure information is treated in a sensitive way
    and is restricted to those who need to see it to make a recruitment decision. By signing this document, you
    allow RMSS LTD to see a copy of the Disclosure. The Disclosure information is not retained i.e. it is disposed
    of within the timescales recommended in the CRB Code of Practice. By signing below, you agree to this


    Any offer of employment is subject to satisfactory screening, that the applicant consents to being screened
    and will provide information as required. That the information provided is correct, and the applicant
    acknowledges that any false statements or omissions could lead to termination of employment.

    I confirm that my consent is explicit, fully informed and freely given for the purposes of this job.

    the information contained on this form is correct to the best of my knowledge and belief. i
    understand that if i am appointed and this information is found to be incorrect then i am liable to

    80 Cambridge Heath Road, London, England, E1 5QJ
    Form of Authority (General)
    I authorise RMSS LTD of 80 Cambridge Heath
    Road, London, England, E1 5QJ to approach individuals and organisations for verification
    of my education, employment and unemployment record and to obtain any other
    information which may be pertinent to my application for employment with RMSS LTD.
    I further authorise RMSS LTD to transfer its findings together with any other information
    obtained to the organisation listed above and understand that it will only be used for the
    purposes of this application for employment.

    Personal referees
    Character referees
    Professional advisors
    Educational establishments
    The Department for Work and Pensions / Job Centres
    The Inland Revenue
    The Criminal Records Bureau
    Disclosure Scotland
    Professional bodies
    Credit referencing agencies
    Companies House

    By signing here, I also authorise RMSS LTD to approach my current/previous employer
    for verification of my employment.
    By signing here, I also authorise RMSS LTD to open my Basic Disclosure certificate
    (which will disclose any unspent criminal convictions) and to transfer it to the organisation
    listed above. I furthermore authorise RMSS LTD to receive from Disclosure Scotland
    email notifications as to whether or not my Basic Disclosure certificate will contain
    information about unspent convictions.

    End of Terms and Conditions