Contractor Application Form

Contractor Application

Fill the form below accurately indicating your potentials and suitability to become a Contractor
Name:*

First NameLast Name
Birth Date*

MonthDayYear
National Insurance Number *
Mothers maiden name *
Town and countrry of birth *
Phone Number:*

Area CodePhone Number
Mobile Number *
E-mail Address:*
How were you referred to us?*

Walk-InAnother ContractorNewspaper AdFacebookTwitterOther (please specify)
Others:
Upload CV:

Upload a File

Cancelof
Skills & Training
Describe your skills:*
Training or Certifications:
References

Please list two (2) references that are familiar with your work life.
Reference 1
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Years Known:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reference 2
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Years Known:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Address History in the past 7 years

Please include all non UK addresses too
Please provide full addresses of where you have lived for the last full 7 years, including your current address. Include non-UK addresses too. Please ask for extra paper if necessary. *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From Date*

MonthDayYear
Date
To Date*

MonthDayYear
Date
Please provide full addresses of where you have lived for the last full 7 years, including your current address. Include non-UK addresses too. Please ask for extra paper if necessary.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From Date

MonthDayYear
Date
To Date

MonthDayYear
Date
Please provide full addresses of where you have lived for the last full 7 years, including your current address. Include non-UK addresses too. Please ask for extra paper if necessary.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From Date

MonthDayYear
Date
To Date

MonthDayYear
Date
Please provide full addresses of where you have lived for the last full 7 years, including your current address. Include non-UK addresses too. Please ask for extra paper if necessary.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From Date

MonthDayYear
Date
To Date

MonthDayYear
Date

Emergency Contact Details

Please notify us of any changes to your next of kin details
Name*

First NameLast Name
Relationship to you *
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Medical Information
Doctors Name *

First NameLast Name
Doctors Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Doctors Number *

Area CodePhone Number
Do you have any known allergies?*

YesNo
If yes, please prvide details:

Medical Fitness Declartion

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.
Please confirm your fitness to provide services listed below by ticking each section and signing and dating the bottom of the form. *

I’m physically fit and able to fulfil the demands of a multi- drop courierI’m not taking any medication that will hinder my ability to drive or manipulate consignments in a safe mannerI have no medical conditions that will hinder my ability to drive or manipulate consignments in a safe mannerI will comply with all manual handling guidelines and not place myself in danger by using unsafe working practicesI have no mental or physical conditions that have not been reported to the DVLA which could affect my ability to drive safelyI will inform EMS if my ability to safely drive or handle consignments changes in the future.
Date*

MonthDayYear
Date
Signature*

Clear
Printed Name*

DVLA Information Disclaimer
Name*

First NameLast Name
I confirm I obtain a Full UK Current driving license, and I give my permission forEMS to conduct a DVLA check, to confirm if I have any points or endorsements outstanding. I can confirm I am also happy for Gold Point Logistics Ltd to conduct DVLA Checks three monthly. I am fully aware should I not meet the requirements of the DVLA check, I cannot provide my services at this time.
Driving License Number *
National Insurance Number *
Current Address on driving license*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Signature*

Clear

Stop and Search Policy

Please read the following carefully and sign and the end to confirm that you understand and agree
Gold Point Logistics Ltd reserves the right to search you and/or any of your property on its premises (this includes Gold Point Logistics Ltd customers car parks) and you agree that may search you/and or your property:
- At any time, if EMS honestly and reasonably believes or suspects 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 it reasonably believes or suspects that you may have drugs and or alcohol
  and/or other inappropriate items in the workplace; or
- as part of its random searching policy; or
- when you enter or leave any EMS customers premises.
Any Issued badges if supplied must be worn and displayed at all times onsite.

Failure to comply with this may result in restricting your access to supply services to EMS customers onsite.
Signature*

Clear
Date*

MonthDayYear
Date

Background Check Download Consent
Under the new GDPR regulations, we need to obtain your consent to store a copy of your Background check result on file if applied for and necessary for the contract that you supply services to.
Please read the following statement and sign to confirm you have understood:

I give my permission for EMS to download and store a copy of my background check report during the provision of my services and to hold for 2 years thereafter under GDPR guidelines.
Signature*

Clear
Name*

First NameLast Name
Date*

MonthDayYear
Date

Automated Decision Making

Service provider eligibility decisions are not based solely on automated decision-making.
Name*

First NameLast Name
Signature*

Clear
Date*

MonthDayYear
Date

GDPR Supplier Privacy Notice
How Long Does the Company Keep Data?

The Company will hold your personal data for the duration of your service provision. The periods for which your data is held after the end of your contract are set out as relevant retention periods (below).

Your Rights
As a data subject, you have a number of rights. You can:
- Access and obtain a copy of your data on request;
- Require the Company to change incorrect or incomplete data;
- Require the Company to delete or stop processing your data, for example where the data is no longer necessary for the purposes of processing; and
- Object to the processing of your data where the Company is relying on its legitimate interests as the legal ground for processing:
If you would like to exercise any these rights, please contact:

Data Protection Officer: Terique Gowie

If you believe that the Company had not complied with your data protection rights, you can complain to the Information Commissioner.

What if you do not provide Personal Data?
You have some obligations under your service provision contract to provide the Company with data. You are required to provide details with regards to your Right to Work in the UK, your driving license status and details relating to your self-employed status i.e. UTR and VAT Registration details.
Certain information, such as contact details, your right to work in the UK and payment details, must be provided to enable the Company to enter a contract for services with you. If you do not provide other information, this will hinder the Company’s ability to administer the rights and obligations arising as a result of the service relationship efficiently.

Retention Periods

How long will we keep your personal information?

We always have your best interests at heart and your personal information will not be retained by EMS for longer than necessary in relation to the purposes for which it was originally collected, or for which it was further processed, subject to certain legal obligations mentioned below.
We will retain personal data in accordance with our data retention policy, set out below. We review our data retention periods for personal information on a regular basis.
We hold personal information relating to: -
1. Supplier Resourcing
2. Successful Supplier - Retained for 1 year after no longer providing services;
3. Unsuccessful Supplier - Immediately destroyed;
4. DVLA Compliance
5. Suppliers - Retained for 1 year after no longer providing services;
6. Accurate CRBs
7. Suppliers - Retained for 1 year after no longer providing services if applied for;
8. Van Insurance
9. Suppliers - Retained for 1 year after no longer providing services if used;
We are legally required to hold some personal information to fulfil statutory obligations, for example Right to Work or to support certain financial transactions.
We will also hold information about your details so that we can respect your preferences for being contacted by us. For data quality purposes we will analyse your data to ensure we do not have multiple versions of information on the same person on our database.
The law allows you to withdraw your consent to any usage of your data, at any time without needing to specify a reason.
You can withdraw your consent by emailing our Data Protection Officer

Sales@emslogistics.co.uk

A Guide to Accessing Personal Information

Want to see your personal information?
Your right to access

You have a right to access information EMS holds about you. Information may be held in files or on computers.

How can you get access?

If you wish to request your personal information you can contact the EMS nominated Data Protection Officer (DPO). You will need to provide the following: -
1. Your name;
2. Any previous names;
3. Your address;
4. Driver No;
5. Date(s) when you provided services to Prospect;
6. What information you want to see/receive.
The DPO will need to confirm your identity and will then search for the information you’ve asked for. EMS aim to respond to all requests as quickly as possible.

Information will normally be sent by post, but you can arrange to collect it from EMS DPO and look through it in person. However, we will not be able to provide ANY information over the telephone.

What you cannot see

We will always give you as much information as we can in line with your request; however, we have an obligation to protect other individual’s privacy, so you will not be permitted to access personal information:
1. About someone else unless they have given their consent in writing or it’s within the law to provide access;
2. From another person who gave it in confidence, or whether its confidential to another person;
3. That might lead to a person being harmed;
4. That may be concerned with crime or is protected by legal professional privilege.
When you think a mistake has been made

If you realise that something, such as any of your personal details, has been wrongly recorded, it can easily be corrected and/or if you disagree with an opinion or with EMS version of events, please inform us:
1. What you disagree with;
2. Your opinion, account or version of what happened.
This will be recorded and included in the records, together with the original entry.

If you want to see your personal information, please write to: -

Data Protection Officer
EMS UK GROUP Ltd (EMS)
71-75 Shelton Street,
London, Greater London,
WC2H 9JQ

Email: sales@emslogistics.co.uk

Telephone: 01708 898925

REMEMBER, WE CANNOT GIVE OUT INFORMATION OVER THE TELEPHONE
Should be Empty:

Contractor Application

Address History in the past 7 years

Emergency Contact Details

Medical Information

Medical Fitness Declartion

Driving History

DVLA Information Disclaimer

Stop and Search Policy

Background Check Download Consent

Automated Decision Making

GDPR Supplier Privacy Notice

A Guide to Accessing Personal Information