CPC D1 Minibus Driver Application Form

Please give details of all driving endorsements/ convictions below

	Reason for endorsement/ conviction	Points applied	Date of Conviction	Endorsements/ convictions expiry date
1.
2.
3.

Do you hold a valid Category D1/D by test (licence MUST NOT state 'nfhr')? *

Yes No
If you hold a valid Category D1/D by test, please upload photos of both sides of your card licence here:

Cancel of

Date Test Passed *

Day Month Year
Approximate date if necessary
Please list other driving entitlements currently held on your licence:
Do you hold a current Drivers Qualification Card (DQC)? *

Yes No
DQC Expiry date?

Day Month Year
Date
Do you have use of a car for travel to work?

Yes No
Do you have a disability which presents special needs at the selection interview? *

Yes No
Are you prepared to work a flexible week, including evenings and weekends? (This post is a minimum of 20 hours per week with flexibility needed for up to 40 hours per week) *

Yes No

Employment Record & Driving Experience

Please demonstrate 2 years relevant driving experience of driving larger vehicles (please list in order, most recent first)

	Name & Address of Employer/ Organisation	Position Held	Date Started	Date Ended	Brief list of duties, to include type of vehicle driven, if applicable	Reason for Leaving
1.
2.
3.
4.
5.
6.

Other relevant information
Please give details of your ability to work on your own initiative, as well as part of a team. *
Please outline your ability to communicate effectively, both verbally and in writing. *
Use the space below to give any other information you feel is relevant to your application.

References

Please list the name, address and contact number of two references - at least one should be a current/previous employer
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

Town/City County

Post Code
Email *
example@example.com
Phone Number
Please enter a valid phone number.
Current employer? *

Yes No
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

Town/City County

Post Code
Email *
example@example.com
Phone Number
Please enter a valid phone number.
Current employer? *

Yes No
Do you have any objection to contact being made with your present employer? *

Yes No

Disclosures

DART adheres to the Access NI Code of Practice, and as required by the Code of Practice we have in place an ex-offenders recruitment policy as well as a policy on the secure handling, use storage and retention of disclosure information. All of these policies and the Code of Practice are available on request. This role involves working in a regulated activity and working closely with adults at risk.
Do you have any convictions that are not 'protected' (as defined by the Rehabilitation of Offenders (Exceptions) (Northern Ireland) Order 1979, as amended in 2014? Enhanced Access NI Checks will be carried out* *

Yes No
Is there any reason why you cannot work in a regulated activity? *

Yes No

If you have ticked yes, summarise the details below. Having a conviction will not necessarily stop you from obtaining employment with DART, but will need to be taken into consideration when assessing your suitability.

Declaration

I declare that the information that I have given is correct:
Signature *

Clear
Date

Day Month Year
Date
*By signing above, you are giving consent for an Enhanced Access NI check to be carried out in line with the requirements of this role and the accompanying regulated activities you will be carrying out.
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