New Contractor Application

CONTRACTOR ENROLMENT FORM
Full Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

DayMonthYear
Date
Phone Number*
Please enter a valid phone number.Format: 00000 000 000.
Email Address*
example@example.com
Emergency Contact Name*
Emergency Contact Phone*
Format: 00000 000 000.
Nationality*
NI Number*
Licence Details
Licence Expiry*

DayMonthYear
Date
Postcode of Licence*
License Number*
YesNo
Bank Details
Sort Code*
Account Number*
By signing this document, you acknowledge that we reserve the right to pass on the cost of the Background Check to you at a future date.
Signature

Clear

DISCLOSURE REGARDING CONSUMER AND/OR INVESTIGATIVE REPORT

THIS DOCUMENT CONTAINS IMPORTANT INFORMATION. PLEASE READ IT CAREFULLY.

This process is in English, except for critical disclosures that are provided in select languages.

In order to evaluate candidate suitability for employment (including contract for service), we ("the Company") have implemented a policy of pre-employment screening worldwide. In connection with your application, the Company has engaged Accurate Background to conduct background screening on its behalf.

Screening services are generally defined as, but are not limited to: criminal and civil records checking; education, qualification and employment history verification. The nature and scope of the screening will be relevant to the position for which you have applied and might not include all possible checks.

All screening will be conducted to the extent applicable law allows. Information collected from you will be used solely to assess your suitability for employment and for execution of the employment contract, and will not be used for another purpose.

Accurate Background may also need to disclose your information to third parties such as governmental agencies, educational institutions, previous employers and research partners who can assist in verifying the information you have provided.

Data will be stored on a secure server in the United States, in accordance with Safe Harbor and international (including UK and Ireland) data protection standards. Your data may be transferred outside of the European Economic Area (EEA) and/or any other country as applicable if this is necessary to complete the pre-employment screening process.

For more information about Accurate Background's data protection and privacy policies, please visit the website at http://www.accuratebackground.com/site-harbor-policy.php?sec=6

The consumer and/or investigative consumer report(s) will be obtained from: Accurate Background, Inc., 7515 Irvine Center Dr. Irvine, CA 92618.

Accurate Background's information and privacy policy can be found at www.accuratebackground.com.
NoYes
If yes please briefly explain the type of offense date and location of the occurrence and the disposition
CRIMINAL RECORD DISCLOSURE DATA
Name*

First NameMiddle NameLast Name
Town of Birth*
MOTHERS LAST NAME AT BIRTH*
MOTHERS FIRST NAME AT BIRTH*
MOTHERS MAIDEN NAME*
Passport Country*
PASSPORT NUMBER*
ISSUE DATE*

DayMonthYear
Date

ADDRESS HISTORY

For this next section, you are required to provide all addresses you have lived at for the last 7 years.
CURRENT ADDRESS 1:
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
DATE MOVED IN*

DayMonthYear
Date
PREVIOUS ADDRESS 1:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
DATE MOVED IN

DayMonthYear
Date
PREVIOUS ADDRESS 2:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
DATE MOVED IN

DayMonthYear
Date
PREVIOUS ADDRESS 3:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
DATE MOVED IN

DayMonthYear
Date
PREVIOUS ADDRESS 4:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
DATE MOVED IN

DayMonthYear
Date
PREVIOUS ADDRESS 5:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
DATE MOVED IN

DayMonthYear
Date

I give Accurate Background and their representative's permission to:

Obtain information on criminal convictions I may have which are unspent according to the Rehabilitation of Offenders Act 1974; use and store my personal information, including anything that is sensitive, for the sole purpose of performing the background check; contact me directly to get any information Accurate Background needs to carry out Basic Disclosure checks on me and to verify my information before passing it on to my current or new employer (or people acting for them); give my information to other organisations-such as local and central governments, the police, courts and tribunals, and legal advisers-for them to use only as necessary to process the background check; and give my personal information to my current or new employer to the extent applicable law allows.

Permission to use information under the Data Protection Act 1998:

I give all government organisations and others permission to give Accurate Background and my current or new employer (or people acting for them) information about my background (including information about my driving records, criminal records, and other public records) to determine my suitability for employment. I agree that my personal information can be used outside of the European Economic Area, in accordance with applicable law, if this is necessary for employment screening purposes. I also give Accurate Background and their representative's permission to give my personal information to other organisations if required to carry out the checks. I understand that all handling of my personal information by Accurate Background and other organizations will be limited to performing the background check.

By signing below I confirm that I have read and understood Accurate background's privacy policy regarding personal information (shown on the website at http://www.accuratebackground.com/siteharbor-policy.p?sec=6)
Signature*

Clear
Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Todays Date*

DayMonthYear
Date
Hour Minutes
True and Complete Statement:

I declare that the information provided in this form and any other documents submitted by me are true and complete. I understand and agree that any false information or omission by me may result in the rejection of my application, or if I am employed, the termination of employment. In order to access my suitability for employment (including contract for service), I understand that The Company will conduct pre- employment screening and has engaged Accurate Background, Inc. to verify the information I have provided including, but not limited to: criminal and civil records; education, qualification and employment history, and; driving and credit records. I understand that the information I provide will be verified, and research will be conducted using the appropriate sources and to the extent relevant law allows. I consent, without reservation, for the Company and its representatives to conduct pre-employment screening, and I further authorize organisations in any country to assist and provide any information necessary to complete this verification process. I agree to my personal information being transferred outside of the European Economic area and/or any other country as applicable if this is necessary to conduct the pre-employment screening process.
Signature*

Clear
Todays Date*

DayMonthYear
Date
Hour Minutes

ACKNOWLEDGMENT AND AUTHORIZATION FOR BACKGROUND CHECK

By submitting your information, you consent to the collection, use and storage of your information as outlined above. You also authorize organizations in any country to give your personal information to the organizations referred to above, and to your employer to the extent applicable law allows. Your consent will apply unless you revoke or cancel it by sending a signed letter or statement to the Company at any time.

I understand the information presented above.

I consent, without reservation, to the Company and its representatives to conduct pre-employment screening, and I further authorize organizations in any country to assist and provide any information necessary to complete this verification process. I acknowledge receipt of the DISCLOSURE REGARDING CONSUMER AND/OR INVESTIGATIVE REPORT and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT and certify that I have read and understand both of those documents. I hereby authorize the obtaining of "consumer reports" and/or "investigative consumer reports" by the Company at any time after receipt of this authorization and throughout my employment, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, local, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by Accurate Background, Inc., 7515 Irvine Center Dr. Irvine, CA 92618, www.accuratebackground.com another outside organization acting on behalf of the Company, and/or the Company itself.

I understand that by signing below, that I am providing the Authorization form directing the background check as described above, and I certify that:

I have received the Disclosure Regarding Consumer and/or Investigative Report, have read and received the Summary of Your Rights, and if a California resident/applicant, the A Summary of Your Rights Under the Provisions of California Civil Code $1786.22. I understand that my electronic signature now and throughout this process will be binding as though I had physically signed these documents by hand. Additionally, notices, documents, and communications may be provided electronically and will meet the requirements set forth under Federal and/or State law, as permitted by law. I agree that a facsimile ("fax"), electronic or printout of this authorization may be accepted with the same authority as the original.
Name*

First NameLast Name
Signature*

Clear
Todays Date*

DayMonthYear
Date
Hour Minutes

Medical Fitness Declaration
All couriers wishing to provide services must be medically fit enough to undertake the role as a multi-drop courier. The core role involves a significant amount of driving and the safe manual handling, manipulation, sorting and delivery of large numbers of consignments.
I'm physically fit and able to fulfill the demands of a multi-drop courier.I'm not taking any medication that will hinder my ability to drive or manipulateconsignments in a safe manner.I have no medical conditions that will hinder my ability to drive or manipulate consignments in a safe manner.I will comply with all manual handling guidelines and not place myself in danger by using unsafe working practices.I have no mental or physical condiitions that have not been reported to the DVLA which could affect my ability to drive safely.I will inform the company if my ability to safely drive or handle consignments changes in the future.
Date*

DayMonthYear
Date
Signature*

Clear
Name*

First NameLast Name

Nondisclosure and Data Protection Agreements for Contractors
During the course of your work/time with us ("the Company" and "us"), you will be invited to visit our premises and our clients, where you may receive information relating to the Company that is not known to the general public and is confidential and important to us. We call this our "Confidential Information". Our Confidential Information includes, among other things,
- The way that we work
- The layout of our premises
- The technology that we use including computers and machinery
- That goods that we stock and the way that they are stored
- The people we work and interact with The people and companies who deliver to us and collect from us
- Any details about our customers, including their names, addresses and what they buy
- Anything to do with finance
- Anything to do with advertising or marketing plans
- Anything that you hear
Our Confidential Information is very important to our business. It is vital to us that it does not become known to other companies. We will take all legal steps necessary to protect our Confidential Information.

You must agree to the following commitments;
1. You will not disclose our Confidential Information to anyone or any company.
2. You will use our Confidential Information only to make up your mind about working with us.
3. You will notify us immediately if you discover that our Confidential Information has been disclosed, however it happens.
4. All our Confidential Information will remain our property.
5. You will not trade stocks or shares based on our Confidential Information.
6. You will return any materials containing our Confidential Information to us if we ask you to.
7. You also agree that you will not disclose information to us that is confidential to you or anyone else.
This is a legal agreement.

If a provision of this agreement is held invalid under any applicable law, such invalidity will not affect any other provision of this agreement that can be given effect without the invalid provision. Further, all terms and conditions of this agreement will be deemed enforceable to the fullest extent permissible under applicable law, and, when necessary, the court is requested to reform any and all terms or conditions to give them such effect.

We are relying upon your promise to comply strictly with this agreement. Any violation of this agreement may cause substantial and irreparable harm to us. Accordingly, without limiting any other available remedies, this agreement is specifically enforceable by us.

Any failure by us to enforce your strict performance of any provision of this agreement will not constitute a waiver of out right to subsequently enforce such provision or any other provision of this agreement.

I understand and agree to abide by the promises I make in this agreement to protect the Company Confidential Information. I agree that my promises also apply for the benefit of other associated companies.
Signature*

Clear
Name*

First NameLast Name
Date*

DayMonthYear
Date
Time*

Hour Minutes

Stop and Search Policy
Please read the following carefully and sign and the end to confirm that you understand and agree

This policy applies to all contractors and anyone working at or visiting our sites.

We and our customers ("us", "our" and "we") reserve the right to search you and/or any of your property on its premises (this includes our car parks) and you agree that we may search you/and or your property:
- at any time, if we honestly and reasonably believe or suspect that you may be in possession of, have destroyed, tampered with, concealed or handled stolen goods or has evidence of any theft or attempted theft;
- or if we reasonably believe or suspect that you may have drugs and or alcohol and/or other inappropriate items in the workplace;
- or as part of our random searching policy; or when you enter or leave our premises.
Issued badges must be worn and displayed at all times onsite.

Failure to comply with this may result in restricting your access to our building.
Signature*

Clear
Name*

First NameLast Name
Date*

DayMonthYear
Date
Time*

Hour Minutes

CONTRACTOR ENROLMENT FORM

Licence Details

Bank Details

CRIMINAL RECORD DISCLOSURE DATA

ADDRESS HISTORY

CURRENT ADDRESS 1:

PREVIOUS ADDRESS 1:

PREVIOUS ADDRESS 2:

PREVIOUS ADDRESS 3:

PREVIOUS ADDRESS 4:

PREVIOUS ADDRESS 5:

Medical Fitness Declaration

Nondisclosure and Data Protection Agreements for Contractors

Stop and Search Policy

Non-UK Driving Licence Declaration