WELCOME TO EVENT FIRE SOLUTIONS 
AN INDEPENDENT FIRE 
AND RESCUE SERVICE 
0800 999 4343 
 

Medical Recruitment Form 

If you would like to join the EFS medical team, please use the application form below. 
 
Details entered in this part of the form will be held in the HR Department of Event Fire Solutions our parent Company and Access to this information will be withheld from the shortlisting panel. Please do not fill in the form using only capital letters, as this could lead to your application being automatically rejected. Please use the appropriate mixture of capital and lowercase letters in standard written text. 
 
It is essential that you complete this application in full, supplying all relevant attachments and details. 
 
For more information contact us: Tony@efsmedical.co.uk, and alan@efsmedical.co.uk 
PERSONAL DETAILS [*all choices mandatory] 
If you have ever used another forename or surname, you must enter it in the box below, with both 'to' and 'from' dates 
 
From
To
Dates
Dates
CONTACT DETAILS 
Social Media 
What is the best way to contact you? 
Mobile
Landline
Facebook
Letter
Email
Address Details (current
 
If you have lived at the above address for less than 5 years, you must list each previous address (including postcode and date moved) in the box below. This also includes foreign addresses if you have lived/served overseas. 

Previous Addresses 

 
 
 

References 

Reference 1 

 

Reference 2 

Certificates 

Please upload any certificates you hold regarding your application to work with EFS Medical 
Photo 
Other Details 
Yes
No
Yes
No
Tick all classes you hold: 
Car (category B)
Motorbike (categories A1,A2 & A)
Moped (category P or AM)
Medium-sized vehicles (category C1)
Large vehicles & lorries (category C)
Minibus (category D1)
Bus (category D)
Agricultural tractor (category F)
Other specialist vehicles (cat. G,H & K)
Quad bikes & 4-wheeled light vehicles (cat. B1)
Motor tricycle (categories A & A1)
Yes
No
Yes
No
Yes
No
Yes
No
Working for EFS Medical is only on a self-employed basis, are you happy to declare your own Tax and National Insurance? 
Yes
No
Safeguarding 
 
This section of the application will only be seen by those who have a need to see it as part of the recruitment process. Any information you disclose will be treated in the strictest confidence. 
 
Criminal Convictions - Rehabilitation of Offenders Act 1974 
 
The Rehabilitation of Offenders Act 1974 (as amended) helps rehabilitated ex-offenders back into work by allowing them not to declare criminal convictions after the rehabilitation period set by the Court has elapsed and the convictions become 'spent'. During the rehabilitation period, convictions are referred to as 'unspent' convictions and must be declared to employers. 
 
The organisation aims to promote equality of opportunity and is committed to treating all applicants for positions fairly and on merit regardless of ethnicity, disability, age, gender or gender re-assignment, religion or belief, sexual orientation, pregnancy or maternity and marriage or civil partnership. The organisation undertakes not to discriminate unfairly against applicants on the basis of a criminal conviction or other information declared. 
 
You are required to declare all current 'unspent' criminal convictions or cautions (including reprimands and final warnings). You are not required to disclose convictions or cautions which have become 'spent'. 
 
As part of assessing your application, organisations will only take into account relevant criminal record and other information declared which is relevant to the position being applied for. 
 
Answering 'yes' to the question below will not necessarily bar you from appointment. This will depend on the relevance of the information you provide in respect of the nature of the position for which you are applying and the particular circumstances. 
Are you currently bound over or do you have any current ‘unspent’ convictions or cautions (including reprimands or warnings) that have been issued by a Court or Court-Martial in the United Kingdom or in any other country? 
Yes
No
Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2013 
 
The position you are applying for has been identified as being an 'eligible position' under the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 [the Exceptions Order] and, in certain circumstances, the Police Act 1997. As such, it meets the eligibility criteria for a standard or an enhanced disclosure to be requested through the Disclosure and Barring Service (DBS). 
 
Both standard and enhanced DBS disclosure certificates contain information about any convictions, cautions (including reprimands and final warnings) which are not 'protected' as defined by the Rehabilitation of Offenders Act 1974 (Exceptions Order) 1975 (as amended). Enhanced disclosures may also include other relevant police information where this is deemed relevant to the position you are applying for. 
 
Please be aware that the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2013 (S.I. 2013/1198) made 
amendment to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 
to provide that certain spent convictions and cautions will become protected 
when specific conditions are met. Protected convictions and cautions will not be 
disclosed in a DBS check and employers cannot ask for information about 
protected convictions or cautions, or take these into account when considering 
you for appointment. 
 
Before you complete the question(s) below please read guidance and criteria for the filtering of these convictions and cautions which can be found on the Disclosure and Barring Service website at: 
 
www.gov.uk/government/organisations/disclosure-and-barring-service 
 
Where the position has, in addition, been identified as a regulated activity under the Safeguarding Vulnerable Groups Act (2006) (as amended by the Protection of Freedom's Act 2012) an enhanced DBS disclosure will include information which is held on the Children's and/or Adults barred list(s), as applicable to the position. 
 
Please note that you do not need to tell us about convictions, cautions, warnings or reprimands which are deemed 'protected' under the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 as amended by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2013 - see notes above. You also are not required to tell us about parking offences. 
 
Are you currently bound over, or do you have any convictions or cautions (including warnings and reprimands) which are not deemed 'protected' under the amendment to the Exceptions Order 1975, issued by a Court or Court-Martial in the United Kingdom or in any other country? 
Yes
No
Are you currently bound by any barring decision made by the Disclosure Barring Service (DBS) from working with children? 
 
Are you currently bound by any barring decision made by the Disclosure Barring Service (DBS) from working with vulnerable adults? 
DECLARATION 
The information in this application form is true and complete. I agree that any deliberate omission, falsification or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal if employed by the organisation. Where applicable, I consent that the organisation can seek clarification regarding professional registration details. 
I agree to the above declaration
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