** Staff Application Form STAFF APPLICATION FORM STAFF APPLICATION FORMNOTE: This Starter Form will take approximately 15-20 minutes to complete, It is advised to have all relevant documents ready to attach for upload Introduction GDPR Consent * I consent to having this website store my submitted information so they can respond to my inquiry. Tick all that apply to you and attach them for upload Copy of your latest CV Driving Licence Scan Right to work in the UK Visa (for none UK Nationals) National Insurance ID Card Passport Scan Copies of your Non Sentinel Training Certificates Signed Training Agreement Vehicle Usage Agreement Sub Contract Agreement (Assignment) (LTD) CIS Verification Form (LTD) Certificate of Incorporation (LTD) VAT Certificate (LTD) Proof of Business Account (LTD) First Aid Certification (In Date) Upload your files Drop a file here or click to upload Choose File Maximum file size: 67.11MB Applicant Details Position Applied for: Date of Application: Name Name First Name First Name Last Name Last Name Mobile Number Email Date of Birth Sex MaleFemale Nationality United KingdomAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe National Insurance Number PTS (Sentinel) Number Address Address Address 1 Address 1 Address 2 Address 2 City City County County Postal Code Postal Code Address Next of Kin Details Name Name First Name First Name Last Name Last Name Relationship SpouseSonDaughterFatherMotherOther Relationship Email Phone Number Address for Communication Address for Communication Address 1 Address 1 Address 2 Address 2 City City County County Postal Code Postal Code Address for Communication Qualifications (Non Sentinel) Add your Qualification (Only if still valid) plus1 Add minus1 Remove Upload Certificate Drop a file here or click to upload Choose File Maximum file size: 67.11MB Employment History (List last 2 positions) Name of Employer Employed From - To: (Month / Year) plus1 Add minus1 Remove Position held, description of work and responsibilities Salary METHOD OF EMPLOYMENT / BANK DETAILS CHOOSE METHOD OF EMPLOYMENT PAYEUmbrellaContractorLTD Company Company Name Registered Address Company Number VAT Number UTR Number / CIS Status Bank Name & Address Sort Code Account Number References (2 required) Name Name First Name First Name Last Name Last Name May the reference be sought without referring to you first? YesNo plus1 Add minus1 Remove Phone Number Organisation Position Held Working Time Directive WORKING TIME DIRECTIVE I hereby waive the restrictions on the 48hour average weekly working time set out in Working Time Regulations 1998. It is my understanding that only by giving written notice to Electrification Construction Services Ltd can these agreements be terminated Name Name First Name First Name Last Name Last Name Signature signature keyboard Clear Driver Details Do you hold a valid Driving Licence? YesNo Driving Licence Number You must read our Company Driving Polices Highway Code Vehicle Use Policy Drivers Handbook Driving Standards Policy D2 Individual Driver Responsibility Policy I Confirm That I Have Read & Understood The Company Driver Policies1. Have Access to the Highway Code2. Vehicle Use Policy3. Drivers Handbook4. FORS D2 Individual Driver Responsibility Policy signature keyboard Clear ECS Company Policy Statements Have you read the ECS Company Policy Statements? YesNo Ensure You Read the ECS Company Policy Statements Below H&S Policy 2025 Environmental Policy 2025 Quality Policy 2025 Drugs & Alcohol Policy 2025 Fraud & Malpractice Policy 2025 Modern Slavery Policy 2025 Managing Fatigue Policy 2025 Worksafe Policy 2025 I Confirm That I Have Read The ECS Company Policy Statements:1. Health & Safety Policy2. Environmental Policy3. Quality Policy4. Drugs & Alcohol Policy5. Fraud & Malpractice Policy6. Modern Slavery Policy7. Managing Fatigue Policy8. Worksafe Policy signature keyboard Clear Medical Self Declaration Medical Self Certificate Access to Electrification Construction Services Ltd work sites where full Medical Examination is not required Alertness and reasonable physical fitness are essential for duties, which may interact with moving trains. It is therefore important to be accurate with your answers to this questionnaire, although trivial matters should be ignored (e.g. transient dizziness while gardening two years ago). When you declare NO you are accepting a degree of responsibility for your safety. Please study this list and sign the declaration at the bottom. 1. Do you have Diabetes needing Insulin? YesNo 2. Do you suffer from Epilepsy or Fits? YesNo 3. Have you ever had Blackouts, recurrent dizziness or any condition, which may cause sudden collapse or incapacity? YesNo 4. Do you get discomfort or pain in the chest or shortness of breath on exercise e.g. climbing a single flight of stairs? YesNo 5. Do you have difficulty in moving rapidly over short distances, including on slopes, steps or rough ground? YesNo 6. Would you have difficulty looking over either shoulder? YesNo 7. Do you currently have or have had problems with your lumbar or back? YesNo 8. Do you have difficulty with your eyesight (simple problems needing glasses need not be included)? YesNo 9. Do you wear contact lenses? YesNo 10. Do you have difficulty hearing normal conversations? YesNo 11. Are you taking any medication that is giving you dizziness or drowsiness? YesNo 12. Have used drugs of abuse within the last 12 months? YesNo 13. Have you had any alcohol – related illness during the last 12 months? YesNo If you answered Yes to any question please give details Hand Arm Vibration Questionnaire 1. Did previous jobs involve the use of vibrating equipment? YesNo 2. Have you ever suffered from your fingers going white on exposure to cold? YesNo 3. Have you had any tingling or numbness in your fingers after using vibrating equipment? YesNo 4. Are you experiencing any problems with muscles or joints in your hands or arms? YesNo 5. Do you have any difficulty picking up small objects such as screws or nails? YesNo 6. Do any of your hobbies expose you to hand-arm vibration? If yes please give details YesNo If you answered Yes to any question please give details If you suffer from HAV symptons how often does it occur Several times a year? Several times a month? Several times a day? Every day? Does it occur in winter only? Winter and summer? Contract of Sponsorship Full Name and Sentinel ID Number of Primary Sponsor Organisation: Electrification Construction Service Ltd Sentinel ID: 222341 Details of Individual To Be Sponsored: Name Name First Name First Name Last Name Last Name Sentinel Number As the Sentinel Smart Card holder named above I declare that: I have been briefed on and understand my responsibilities and that of the company under the Sentinel Scheme Rules as detailed in PP036 PTS & the Sentinel Scheme Procedure. I have been issued with suitable railway specification PPE and have been instructed how to use it correctly, how to maintain it and how to obtain replacement items. I have been issued with any necessary safety critical equipment required to undertake my role. I have notified the company of all current medical conditions and medication and will notify the company immediately should this change. I understand that Sub Sponsors are permitted in some circumstances but only with written permission from Electrification Construction Services Ltd. I understand that Electrification Construction Services Ltd may de-sponsor me at their discretion but will provide notification and a reason for de-sponsorship. I understand that a breach of the Sentinel Scheme Rules may result in suspension pending an investigation followed by de-sponsorship. I understand that I can request to be de-sponsored if I wish and can do this via the ’My Sentinel’ area of the Sentinel website if required. I understand I can access my personal records in the ‘My Sentinel’ area of the Sentinel Website. To my knowledge I am eligible to work in the UK. I can understand verbal and written communications in English ECS Ltd – Safety Responsibility Statement At Electrification Construction Services Ltd (ECS Ltd), the safety, health, and wellbeing of all employees, contractors, and visitors is our highest priority. We are committed to maintaining a safe and healthy working environment in accordance with all relevant legislation, industry standards, and best practices. As a new member of the ECS team, you are expected to take personal responsibility for safety in the workplace. This means: YOUR RESPONSIBILITIES: Follow All Safety Procedures: Comply with ECS Ltd’s health and safety policies, site rules, risk assessments, and method statements at all times. Use PPE Correctly: Wear and maintain any required personal protective equipment (PPE) as directed and ensure it is used properly. Report Hazards and Incidents: Promptly report all hazards, unsafe conditions, near misses, and incidents to your supervisor or through the appropriate reporting channels. Take Care of Yourself and Others: Work in a manner that does not endanger yourself, your colleagues, or members of the public. Participate in Training: Attend all safety training and briefings provided by ECS Ltd and apply the knowledge gained in your daily work. Challenge Unsafe Acts: If you see something unsafe, you are empowered to speak up or stop work until the issue is resolved. OUR COMMITMENT TO YOU: ECS Ltd will provide: A safe and healthy work environment; The necessary training, supervision, and equipment to perform your role safely; A culture where safety concerns are listened to and acted upon; Clear procedures and expectations around health and safety. Failure to comply with our safety policies and responsibilities may result in disciplinary action, up to and including dismissal. By signing below, you acknowledge that you have read, understood, and agree to abide by the safety responsibilities outlined in this statement signature keyboard Clear Date Submit If you are human, leave this field blank.
