Energy SQEP

Name*
First Middle Last
Date of Birth*
DD dash MM dash YYYY
Home Address*
House Number Street name City County Post Code Country
Home Phone Number*

If you do not have an home phone / landline number please type N/A in the text box.
Mobile Phone Number*

If you do not have an mobile phone number please type N/A in the text box.
Email Address*

If you do not have an email address please type N/A in the text box.
National Insurance Number.*
Driving License*
Car Owner*
Do you have the right to work in the UK and have the ability to provide proof*
Town of birth: (As stated on passport)*
OVERALL SIZES - CHEST INCHES*
If you clicked other please state your chest inches below.
OVERALL SIZES - TROUSER LENGTH*
If you clicked other please state your trouser length below.
Shoe size (UK)*
If clicked other above please state your shoe size here.
Next of Kin Name*
First Last
Please provide the details of who to contact in emergencies
Next of Kin Address
House Number Street name City County Post Code Country

Leave blank if same as your home address.
Next of Kin (Emergency) Phone Number*
Relationship to you (the worker)*

Qualification Decleration
Trade or Skill*

e.g. Fitter, Electrician, Industrial Operative. WARNING - Failure to provide an accurate declaration of qualifications may result in disciplinary action. All candidates must take original certificates with them to the first day of site induction.
QUALIFICATION DECLARATION*
Qualifications / Certificates / Safety Cards Awarding Project Issue Date Expiry Date Can a copy be Provided
QUALIFICATION DECLARATION
Qualifications / Certificates / Safety Cards Awarding Project Issue Date Expiry Date Can a copy be Provided
Qualification Decleration
Qualifications / Certificates / Safety Cards Awarding Project Issue Date Expiry Date Can a copy be Provided
Qualification Decleration
Qualifications / Certificates / Safety Cards Awarding Project Issue Date Expiry Date Can a copy be Provided
Qualification Decleration
Qualifications / Certificates / Safety Cards Awarding Project Issue Date Expiry Date Can a copy be Provided
Qualification Decleration
Qualifications / Certificates / Safety Cards Awarding Project Issue Date Expiry Date Can a copy be Provided
Qualification Decleration
Qualifications / Certificates / Safety Cards Awarding Project Issue Date Expiry Date Can a copy be Provided
Qualification Decleration
Qualifications / Certificates / Safety Cards Awarding Project Issue Date Expiry Date Can a copy be Provided
Qualification Decleration
Qualifications / Certificates / Safety Cards Awarding Project Issue Date Expiry Date Can a copy be Provided
Qualification Decleration
Qualifications / Certificates / Safety Cards Awarding Project Issue Date Expiry Date Can a copy be Provided
If you need any additional space to put down your qualifications / certificates / safety cards use the space below.

EMPLOYMENT RECORD (MOST RECENT FIRST)*

START DATE	END DATE	EMPLOYER	DETAILS OF WORK UNDERTAKEN AND PROJECTS WORKED ON	CONTACT NAME, TEL NO & EMAIL

START DATE	END DATE	EMPLOYER	DETAILS OF WORK UNDERTAKEN AND PROJECTS WORKED ON	CONTACT NAME, TEL NO & EMAIL

START DATE	END DATE	EMPLOYER	DETAILS OF WORK UNDERTAKEN AND PROJECTS WORKED ON	CONTACT NAME, TEL NO & EMAIL

START DATE	END DATE	EMPLOYER	DETAILS OF WORK UNDERTAKEN AND PROJECTS WORKED ON	CONTACT NAME, TEL NO & EMAIL

START DATE	END DATE	EMPLOYER	DETAILS OF WORK UNDERTAKEN AND PROJECTS WORKED ON	CONTACT NAME, TEL NO & EMAIL

START DATE	END DATE	EMPLOYER	DETAILS OF WORK UNDERTAKEN AND PROJECTS WORKED ON	CONTACT NAME, TEL NO & EMAIL

REFERENCES: - PLEASE PROVIDE THREE WORKING REFERENCES
LOGICAL PERSONNEL SOLUTIONS POLICY STATES THAT ALL EMPLOYEES MUST PROVIDE A MINIMUM OF 3 WORK REFERENCES.
1st Reference*
Company Name Address Contact & Position Email / Tel No.
2nd Reference*
Company Name Address Contact & Position Email / Tel No.
3rd Reference*
Company Name Address Contact & Position Email / Tel No.
NUCLEAR INDUSTRY EXPERIENCE
CLEARANCE/VETTING NUMBER & CLEARANCE EXPIRY DATE (please leave blank if you are not yet cleared)*
Counter Terrorism Check number (CTC)
Counter Terrorism Check expiry date.
Type of Clearence
If you clicked other please state your clearance below.
DESCRIBE ANY OTHER DUTIES AND WORK UNDERTAKEN IN NUCLEAR FACILITIES:-
PLEASE LIST LOCATIONS YOU HAVE WORKED:-*
Any Additional Comments
Classified Worker Decleration
ACCURATE INFORMATION FOR YOUR RADIATION DOSE HISTORY IS ESSENTIAL TO ALLOW YOU TO WORK SAFELY IN THE FUTURE. TO MAKE SURE WE HAVE ACCURATE INFORMATION PLEASE FILL IN THE INFORMATION BELOW.
Have you ever worked as a classified worker?*
If yes please give details of employers name and address and dates of employment sites employed at..
Have you been given an end of contract dosage report?*
If yes can you provide a copy?
Have you been given an end of contract dosage report*
If yes, please send us a copy.
Have you ever worked on a nuclear site as a non-classified Worker?*
If yes, please provide details of employers name, address and dates of employment

Diversity Monitoring Form
Logical Personnel Solutions Limited will treat everyone equally irrespective of sex, sexual orientation, gender reassignment, marital or civil partnership status, age, disability, colour, race, nationality, ethnic or national origin, religion or belief, political beliefs or membership or non-membership of a Trade Union or spent convictions.
Which ethnic group do you most identify with?*
If you ticked other please state below.
What is your religion or belief*
If you ticked other please state your Philosophical belief or religion below.
Disability
A disabled person is defined in the Disability Discrimination Act as someone with a physical or mental impairment that has a substantial and long term impact on their ability to carry out day to day activities. This includes progressive and long term conditions from the point of diagnosis such as HIV, Multiple Sclerosis or cancer.
a) Having read the definition above, do you consider yourself to be disabled?*
b) If you answered yes, can you please indicate the day to day activities affected by your disability. (Tick as many as applicable)
- Eyesight
- Hearing
- Speech
- Mobility
- Progressive condition
- Manual Dexterity
- Physical coordination
- Ability to learn or understand, or memory
- Ability to lift, carry or move everyday objects
If you wish, please state your disability here:

We will try to provide access, equipment or other practical support to people with disabilities.
Permission to work in the UK
Do you have immigration permission to work in the UK?*
In line with UKBA guidance on the prevention of illegal working we will need to verify and take a copy of your original ID documentation as evidence of your right to work in the UK if you are to be engaged by [insert name of agency] for temporary work.
Declaration
I understand that the information I have provided above will be recorded and processed by HR manually and/or electronically in accordance with the Data Protection Act 1998 and the data protection principles contained therein.

Step 1 of 6 - Personal Details

Qualification Decleration

REFERENCES: - PLEASE PROVIDE THREE WORKING REFERENCES

NUCLEAR INDUSTRY EXPERIENCE

Classified Worker Decleration

SQEP Health Assessment

Diversity Monitoring Form

Disability

Permission to work in the UK

Declaration

Criminal Convictions Declaration Form

Energy SQEP

Step 1 of 6 - Personal Details

Qualification Decleration

REFERENCES: - PLEASE PROVIDE THREE WORKING REFERENCES

NUCLEAR INDUSTRY EXPERIENCE

Classified Worker Decleration

SQEP Health Assessment

Diversity Monitoring Form

Disability

Permission to work in the UK

Declaration

Criminal Convictions Declaration Form

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