Office Use Only

Employment Application Form We welcome applications from all people with the relevant skills and potential for the job. Please answer the questions in this form as honestly and fully as possible, incomplete forms will not be considered and CV’s will not be accepted as a substitute for incomplete forms. The information given in part one, which contains personal information, will be detached from the rest of the form and only the information given in part two will be used for short-listing purposes. Should your application be successful, you will be required to provide certain documentary evidence before commencing employment (e.g. birth certificate, educational qualifications, national insurance and income tax details, passport).

PART I

Nearest Railway Station to your home

Surname Date of Birth* Forenames (First names)

Title

Miss

Mrs

Ms

/

Mr

Other (please specify)

Age* /

National Insurance No.

Do you need a working permit to work in the UK?

Address

Yes

No

Are you able to provide your own transport to travel to work? Yes

No

Job Applied for Job reference number ATW Location of job Postcode

Telephone number and email, where you can be contacted Home Telephone

Mobile Telephone

Full time

Part time

Are you able/ willing to work shifts (including nights and weekends) if the job requires it? Yes Have you previously been interviewed/ worked for this company or another Rail Industry company? Yes

No

No

If yes, which company? Location

Position

Work Telephone

email Address * Age limits apply to certain types of work. Please ask if you are unsure how these may affect your application.

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Diversity Monitoring - Equal Opportunities It is Arriva’s vision to become Europe’s leading transport organisation. We believe that a diverse workforce, that more closely reflects our customer base, will help to shape this vision. In line with our equal opportunities policy, we are committed to base our selection decisions on merit alone, irrespective of ethnic origin, nationality, age, sex, marital status, sexual orientation, religious belief, political opinion or disability, where this is not clearly justifiable. For us to be able to monitor that this policy is fully and fairly implemented, please provide the information below (choosing not to complete this section will not affect your application): Gender Please indicate your gender

Disability Do you consider yourself to have a disability?

Male

Yes

Female

No Ethnic Origin Ethnic origin questions are not about nationality, place of

If yes, please give brief details of the nature of your

birth or citizenship. They are about colour and broad

disability:

ethnic groups – UK citizens can belong to any of the following groups. Please indicate which ethnic group most closely resembles yours. White English

Scottish

Welsh

Irish

Arriva Trains Wales is a Positive About Disabled People employer. Please give details below of any special arrangements you may need for interview, or to carry out the job effectively.

European Other white, please state Mixed White/Black

Carribean

White/ Black African

White/ Asian

Language ability Please indicate which languages you consider yourself

Other mixed, please state

fluent in: Asian

English Indian

Pakistani

Bangladeshi

Welsh

Other, please state If the job you are applying for specifies that fluency in

Other Asian, please state

Welsh is required, this section will also be used at shortlisting stage.

Black Caribbean

African

Military Reserve Are you a member of the military reserve?

Other black, please state

Yes

Chinese

No

Other, please state

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Recruitment Where did you learn about this job vacancy? Please tick the appropriate box/es. Newspaper, local*

Newspaper, national*

Trade Journal*

Jobs Publication*

Word of Mouth

Internet Site*

Arriva Open day

Radio

Cold Call

Internal Notice

Job Centre

*Please give details

References Please give full contact details of two referees. One referee must be your current / most recent employer. The second referee should be from your previous employer. Where this is not possible, we will accept a personal reference from someone who has known you for at least five years and is neither a family relative nor a friend. Name:

Name:

Position:

Position:

Company name:

Company name:

Relationship to you:

Relationship to you:

Address:

Address:

Postcode: Telephone number: (Home)

Postcode: Telephone number: (Home)

(Mobile)

(Mobile)

Fax Number:

Fax Number:

Email:

Email:

Please give an indication of your non availability for interview over the next two months.

Rehabilitation of Offenders Act Have you been convicted of any criminal offence*? Yes

No

Date of conviction:

If ‘Yes’, please give details: Nature of Offence:

Any false statement could disqualify your application, or in the event of employment, render you liable to dismissal. *You are not required to disclose convictions now spent under the Rehabilitation of Offenders Act 1974.

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Office Use Only

Job refernce number ATW

Employment History/Work Experience Please specify your employment history covering the past 10 years, beginning with your current/ most recent employment and working backwards. Please continue on a separate sheet if necessary. This section should include an outline of your job duties, key responsibilities and achievements

PART II Start Date:

Organisation/ Company (including address)

Position held / Nature of work

Finish Date:

What is your current notice period?

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Reason for leaving

Education and Training Please give details of any qualifications you have achieved or courses you have attended. Please continue on a separate sheet if necessary. School, Secondary Education, Higher Education Type of qualification and Subjects

Grade

Name and address of school, College or University

From/ To

Further Education (eg. technical college, trade qualifications and qualifications attained in work) Type of qualification and Subjects

Grade

Name and address of awarding body

From/ To

Personal Development, including evening classes, any craft or other training Type of training or Course title

Name and address of institution

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From/To

Reason for applying Please use the space below to tell us why you think you are suitable for the job and why you are interested in it. Before you answer this section, please ensure you carefully read all the information provided about the company and the job. It is a good idea to spend some time to prepare this section. Please continue on a separate sheet if necessary.

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General Health Some of our posts require the occupants to meet nationally laid down standards for physical, visual and auditory health. If you are applying for the post of Driver, Conductor or other posts, which influence the running of trains, you must complete this section. For jobs where the above does not apply, information on weight, height, colour vision and laser eye treatment is not required, although you may provide it if you wish. All applicants should complete information on sickness absence and medical conditions/problems causing frequent absence. How much do you weigh?

Do you have any medical conditions/problems that could cause you to be absent from work?

kg/st

Yes How tall are you?

No

metres/feet

If yes, please give details:

Do you have defective colour vision? Yes No Don’t know

How many days have you been absent from work during the past 12 months due to sickness? Please give brief reasons and dates

Have you received surgical treatment for near sightedness (laser or photo-refractive eye surgery)? Yes No absence in the last 12 months

No

Declaration

Data Protection Act

I declare that all information given by me on this application form is correct. I understand that my application may be rejected and that I may be dismissed if I have given false information or withheld any relevant details. By signing below, I consent to my personal data, including sensitive personal data being retained and used by Arriva Trains Wales Ltd for the purpose described. I also consent to my personal data being passed to third party organisations as set out below.

The information you provide on this form will be used for recruitment purposes and will only be used in accordance with which it has been collected by Arriva Trains Wales Ltd. All personal information gathered will be processed, stored, maintained and destroyed in accordance with the principles of the Data Protection Act 1998.

Signature:

Date:

/

/

Arriva Trains Wales Limited/Trenau Arriva Cymru Cyfyngedig Registered in England and Wales Number 04337645 Registered Office St. Mary's House, 47 Penarth Road, Cardiff, CF10 5DJ

We may disclose your information as required by law or to carefully selected third parties who may process data on our behalf, such as our appointed agents and service providers for the purpose of psychometric testing, medical examinations and associated arrangements, or for other similar services which are necessary for selection or recruitment purpose. They or we may contact you by mail or telephone in connection with your application. PLEASE RETURN THIS FORM TO: Recruitment Department Arriva Trains Wales St Mary’s House 47 Penarth Road Cardiff CF10 5DJ

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Conductor Supplementary Application Form Please complete the sections below. What you write below will form part of your application and will be used at the short-listing stage. 1. Have you ever done shift work?

Yes




No




If yes, what were the shifts?

Please give details of weekend and bank holiday working you have.

2. Have you ever worked with the general public in a customer services role?

Yes




No




What was your role?

What part of your job involved dealing with the public?

Was it face to face?

Yes




No




Continued over page

Conductor Supplementary Application Form updated 2010

3. Describe a time when you have had to work closely with rules and procedures. (You can use an example from your work or private life.)

What were the rules and procedures?

When under pressure, how did this affect the way you followed these rules and procedures?

How did this make you feel?

4. Give an example of when you took control of an unexpected situation. (You can use an example from your work or private life.)

What happened?

What did you do and why?

How did this make you feel?

What was the outcome?

Conductor Supplementary Application Form updated 2010