Employment Application Form

TransPennine Express

PLEASE NOTE: This application form must be completed in full. Attached CVs will NOT be accepted.

1. Position details
Reference number:
(Ofce Use Only)

Vacancy List number:

(Internal Applicants Only)

Job applied for:

Full or Part Time position Location of job:

Are you willing to work shifts/weekends?

Nearest railway station to place of residence:

Please list any dates when you would be unable to attend our selection process within the next 6 months due to holidays, appointments, etc.

2. Education and training details

Please provide details of any examinations taken, as well as training courses attended. Please include qualications awarded (where applicable) and any membership of appropriate professional bodies. Evidence of qualications may be required before employment is offered. A separate piece of paper may be used if required. Subject Type of qualication/ training Grade attained Name of school/college/ organisation

3. Employment history
Please provide details of your employment history, including voluntary and unpaid work, as well as any periods of unemployment. A separate piece of paper may be used if required. Please ensure all details are correct. Employers
during the last two years will be contacted for reference purposes on appointment (see also Section 7 References).

Current employment Name and address of employer Position held Duration of time in current role Current salary details Why do you wish to leave?

Please outline present duties/responsibilities, skills developed and notice period

Previous Employment
Organisation/company and address Position held plus brief description of duties/ skills developed Duration of time spent in role Why did you leave?

4. Working time regulations

If you are successful in this application, will you continue to work for another employer? Yes No

If yes, how many hours a week will you work for the other employer?

5. Additional information
Please say why you are applying for this role and tell us why you believe you would be suitable. We will be looking for evidence that you have what we require from the ideal candidate. You may nd it useful to refer to the job advert and any other information that you have been given at this stage, which will tell you what skills, abilities, knowledge and experience we are seeking. Please include in this any management, organisational, nancial skills, etc. that you may have gained from voluntary work, unpaid work, community activities or through domestic / family experiences. A separate piece of paper may be used if required.

6. Candidate references (external candidates only)

Offers of employment are subject to receipt of two satisfactory written references. Please provide the names, addresses and telephone numbers of two referees. One of your referees must be your present / most recent employer (or academic reference, if appropriate). The other may be a previous employer / work supervisor or professional person who is able to give you a character reference but is not a social friend. References from friends and relatives are not acceptable.Your contract may be terminated without notice or pay in lieu of notice, if you have been engaged before the Company has received references and these prove unsatisfactory. Current/most recent employer Company Name Second reference Name

Contact Name and Job Title

Job Title

Address

Address

Telephone number

Telephone number

What is your connection with this referee? (e.g. manager, supervisor, colleague, etc.)

What is your connection with this referee?

Duration of time spent working for employer Years: Months:

How long have you known this person?

May we approach this referee prior to making a written job offer? (Please tick the appropriate box) Yes No

May we approach this referee prior to making a written job offer? (Please tick the appropriate box) Yes No

7. Rehabilitation of offenders
Have you ever been convicted of a criminal offence. (declaration subject to Rehabilitation of Offenders Act 1974) YES NO

If you have ever been convicted of a criminal offence, please give details of offence(s) that are not spent, including date(s) and sentence(s): Date Offence Sentence

In an event of employment, any failure to disclose such convictions could result in dismissal without notice or pay in lieu of notice, or other disciplinary action. Any information given will be completely condential and will be considered only in relation to an application for positions to which the order applies.

8. Health and tness

Prior to appointment, the successful applicant(s) will normally be required to undergo medical assessment by doctor(s) / nurse(s) appointed by the Company, plus drug and alcohol screening. Appointment will then be conditional upon receipt of a satisfactory medical and drug & alcohol screening results. In the meantime, please tell us: Your total number of days sickness in last 12 months The number of periods of absence in the last 12 months

Do you have a medical problem that may cause you to be absent from work?

Do you have defective colour vision? How Tall Are You? (Trainee/Train Driver applicants only)

Have you had laser or other surgery to correct your vision?

How much do you weigh?

9. Data protection
Once the recruitment process is complete, the data will be stored for a maximum of twelve months in case of future employment opportunities and then destroyed. If you are a successful candidate, relevant information will be taken from the form and used as part of your personal record held by the HR / Payroll Teams and your Line Manager. Under the Data Protection Act 1998 you are entitled to be given a copy of most of the information we may hold about you. We cannot reveal, without their consent, the identities of individuals who may have provided any of that information. If, at any time, you wish to see a copy of the information we are holding about you, please write to: The Data Protection Ofcer, First Great Western / First Great Western Link, Milford House, 1 Milford Street, Swindon SN1 1HL.

10. Declaration
I declare that the information given on this form is correct to the best of my knowledge and belief. I understand that my application may be rejected and / or offer withdrawn if I have given false information or withheld relevant details. I also understand that if it is found subsequent to my appointment that inaccurate details have been provided or relevant details withheld, this is liable to result in summary dismissal without notice or pay in lieu of notice. I consent to the company processing my personal data, as well as my sensitive personal data, given here (and on the Equal Opportunities Monitoring Form for the purpose of equal opportunities monitoring) for purposes of my employment, for administrative purposes (including providing any future prospective employers with a reference and safety record) and for the purpose of complying with applicable laws, regulations and procedures. Signed: Date:

Thank you for taking the time to complete this form

11. Returning the forms
On completion of this form, the personal information sheet, equal opportunities monitoring form and any other supporting documentation, please return them to the address below (unless instructed otherwise): TRANSPENNINE EXPRESS RECRUITMENT 7th FLOOR BRIDGEWATER HOUSE 60 WHITWORTH STREET MANCHESTER M1 6LT

Reference Number:

12. Personal information

This page does not form part of the short listing process and will be detached on receipt of the application and held condentially. SECTION 12 MUST BE COMPLETED. Surname Forename(s)

Previous surname(s)

Title (e.g. Ms, Mrs, Miss, Mr, Dr)

Name you wish to be known by

Date of birth

National Insurance number

E-mail address

Home telephone number

Between what times may we contact you on this number?

Mobile telephone number

Between what times may we contact you on this number?

Work telephone number

Between what times may we contact you on this number?

Home/permanent address

Address to which correspondence should be sent (if different from home/permanent address)

Forename(s)

Surname

Ref No:

Equal opportunities monitoring form

This form does not form part of the selection process and will be detached on receipt of the application and held condentially. We are committed to the operation of employment procedures and conditions that provide for equal opportunities. Our policy aims to ensure that unfair discrimination does not take place at any stage in recruitment and employment. In order to help us monitor the effectiveness of this policy, we would appreciate it if you could provide the information requested below. Any information provided will be condential and stored and used in accordance with the Data Protection Act 1998 for the purposes of equal opportunities monitoring only. There is no legal requirement to keep information on how staff groups are made up (gender, religion or belief, ethnic groups, age and those with disabilities). Such monitoring is considered good practice. The information will help us to make sure our Equal Opportunities Policy is working to the benet of all our staff. The information provided may help us understand our employees needs. A detailed knowledge of the composition of our workforce will help us to assess the need to change existing or provide additional practices having regard to different dietary and dress requirements and being aware of particular disabilities. We must stress that this information is strictly condential and will not be seen or used by anyone making selection decisions or taken into account during any subsequent employment. We appreciate that some people may nd some of the questions extremely personal and we must, therefore, make it clear that you are under no obligation to answer questions that you do not wish to answer. If you do not wish to answer such questions, this will not affect your application in any way. However, we do ask that, in any event, you return the form to us to ensure that we can full our equal opportunities monitoring requirements.

1. Ethnic origin
What is your ethnic group? Choose one selection, and then tick the appropriate box to indicate your ethnic background. The classications we have used are those recommended by the Commission for Racial Equality. White English Irish British or Mixed British Scottish Welsh Any other White background. Please state:

Asian or Asian British Bangladeshi Pakistani Indian Any other Asian background. Please state:

Black or Black British African Any other Black background. Please state: Caribbean

Chinese Chinese Mixed White and Black Caribbean White and Asian White and Black African Any other mixed background. Please state:

Other ethnic group Please state:

2. Nationality
What is your nationality? Please state:

3. Asylum and immigration act

Under Section 8 of the Asylum and Immigration Act 1996, it is an offence to employ an individual who has no right to work in the UK or has no right to do the work that we are offering*. Therefore, should your application be successful, you will be required to provide the necessary documentation proving your eligibility to be employed. (*This includes students who can only work limited hours as well as people who have a work permit to do a particular job) Do you have evidence of your entitlement to live and work in the UK? Yes No

If your application is successful, you will be asked to produce this evidence. (e.g. a full current UK / EEC Passport / National Identity Card or appropriate Home Ofce documentation conrming permission to take employment, etc.) Do you require a work permit? Date of expiry of permit held: Yes No

4. Gender
What is your gender? Please tick the appropriate box. Female Male Other :

5. Age
What is your age category? Please tick the appropriate box. 24 and under 25-34 35-44 45-54 55-65 Over 65

6. Disability
The Disability Discrimination Act 1995 denes a disability as a physical or mental impairment, which has a substantial and long-term adverse effect on your ability to carry out normal day-to-day activities. Do you consider that you have a condition (medical or otherwise) which would be likely to have an effect on your ability to carry out your employment? Please tick the appropriate box. Yes No

If YES, please describe below what, if any, reasonable adjustments you would need to enable you to participate effectively at one of our selection events, e.g. visual aids, appropriate interview times, etc.

If YES, is there anything we need to know to assist you with mobility should we need to evacuate the building for health and safety purposes, re drills, security alerts, etc.?

7. Religion or belief
To which religion/belief group do you belong? Please tick the appropriate box. Astaru Christian Jainism Paganism Shamanism Sikhism (*) Please describe, if ticked
(Based on the classications adopted in the ACAS Guide Religion Or Belief In The Workplace)

Bahai Hinduism Judaism Wicca Zoroastrian (Parsi) Other (*)

Buddhism Islam (Muslim) Druidry Odinism Rastafarianism Do not wish to answer

8. How did you hear about this job?

Please indicate where you rst heard about the vacancy for which you are applying by ticking the appropriate box and completing any additional information requested. Press advertisement From which publication? From a member of staff Who?

Speculative application Internet Careers ofce

Company internal vacancy list Telephone inquiry School / college / university

Jobs fair / career day Job centre Other Please provide brief details:

Poster campaign station / on train

9. Data protection act

Information provided by you on the Equal Opportunities Monitoring Form will be kept for the purposes of monitoring. Once the recruitment process is complete, the data will be stored for a maximum of twelve months and then destroyed. If you are the successful candidate, relevant information will be taken from the form and used as part of your personal record held by the HR / Payroll Teams.

Thank you for taking the time to complete this form Please return this with your completed employment application form

Acknowledgement
If you wish to receive acknowledgement of this application please complete your details below. Title Address Full Name

This slip is to acknowledge that your application has been received by the Human Resources Department at TransPennine Express.