MSS General Application Form

Please attach current CV

This must be in .doc, .docx or .pdf format

*

Personal Details

Name*

Title First Last

Address*

Street Address Address Line 2 City County Post Code Country

Mobile Number

Home Number

Work Number

Email address (this should be one you can respond to within 1 working day)*

Do you have the right to work in the UK?*

Yes
No

Qualifications

Please list below all Professional Qualifications you have obtained

Qualification, Grade and Level Obtained	Date Obtained

Other Qualifications

Please list below any other relevant training or qualifications

Details of Courses or Qualifications	Date Obtained

Employment History

*

Please list below your most recent work experience first, including any other companies or agencies you work for, whether on a permanent or ad-hoc basis: (or fill with 'See CV' if CV has been uploaded)

Date From - Date To	Name of Employer	Position Held

Referees

Please give details of two people of whom we can obtain references. One should be your current or most recent employer.

Referee Name*

Occupation*

Email address (full postal address if not available)*

Referee Name*

Occupation*

Email address (full postal address if not available)*

Disclosure of Convictions

Do you have any criminal convictions except those ‘spent’ under the Rehabilitation of Offenders Act 1974.*

Yes
No

We will require a copy of a current DBS check if you are selected to join the Network

Please note convictions below:

Employment Dismissal

Have you ever been dismissed from employment for any reason other than redundancy?*

Yes
No

Please give details

Where did you hear about this role?*

What are your salary expectations?*

Declaration*

I confirm that to the best of my knowledge, the information given is true and correct. I understand that should I knowingly make a false statement or conceal any material in connection with this information form, this may disqualify my appointment to MSS’s independent contractor network.