Application Form

Personal Information

All required fields are marked with an asterisk (*)

Click here to open signature pad

Forename

Middle Name

Surname

Sex

Email Address

Mobile Number

Home Number

Address

House Name / No

Address Line 1

Address Line 2

Town

District

County

Postcode

Country

Payment Details

Bank Name

Account Number

Roll Number

Account Holder's Name

Sort Code

Miscellaneous

Nationality

NI Number

Marital Status

Next of Kin

Next of Kin Contact No

Legally entitled to drive

SIA Number

SIA Expiry Date

Address History

Address history must go back 5 years.
Once you have completed each reference, press the 'Add Address' button.

Postcode	Start Date	End Date
Previous addresses you add will be displayed here

Residence Type

Resident From

Resident To

House Name / No

Address Line 1

County

Postcode

Country

Employment References

References must go back a minimum of 5 years or back to school. Gaps in employment may require additional proof.
Minimum of 1 references required.
Once you have completed each reference, press the 'Add Reference' button.

Status	Company	Start Date	End Date
Employment references you add will be displayed here

Start Date

Are you currently employed here?

End Date

Company Name

Reference Forename

Reference Surname

Email Address

Telephone Number

Address Line 1

County

Postcode

Country

Job Title

Job Type

Background Information

Are there any current prosecutions pending against you?

Health Screening

Are you on medication?

Driving

Do you have access to your own transport?

Background Information

Do you have any outstanding CCJ's?

Driving

Do you hold a full driving licence?

Background Information

Have you ever been convicted or cautioned for any offence?

Health Screening

Have you had any alcohol-related illnesses during the last twelve months?

Have you used any illegal substances within the last twelve months?

Statements and Declarations

I consent to my submitted data being collected and stored to the terms of the privacy policy, found here

I have checked these details are correct. I confirm I have the permission of the referees I have provided on this form to pass their personal details to you. I understand and agree to Regency Security Group Ltd using this and other data to create and maintain records on me and for statistical purposes in accordance with the Data Protection Act 2018. I agree to allowing my details to be passed to the external payroll provider, First Payroll Services STM Limited. I agree that this information will be kept for the duration of the recruitment process and for a period of time thereafter. Should I be employed I agree that this information will be kept for the duration of my employment and for a period of time following this. I am aware I have the right to request a copy of the data held on me. Regency Security Services (UK) Ltd will process data about you for a variety of purposes including all aspects of the administration of your employment. This will include your data being used to produce statistics to show workforce trends.

Background Information

If yes, please give details

If yes, please provide details

Health Screening

If you have answered "Yes" to any of the above, please give details

Background Information

Please note that failure to disclose a conviction/unspent conviction/caution, which is later detected through vetting may result in termination of employment from Regency Security Services Ltd.

Personal Information

What is your collar size in inches?

What is your height in feet and inches?

What is your jacket size in inches?

What is your weight in kg?

Statements and Declarations

I confirm that Regency Security Services have my permission to request to receive references from the employment referees that I have supplied on this application form.