IN STRICTEST CONFIDENCE

Christmas Casual Registration

and Security Checks Consent Form
Please complete in black ink and write clearly in block capitals.
Please note that the Royal Mail Group undertakes mandatory security checks for recruitment and appointment
purposes in line with company policy, the Police Act 1997 and the Data Protection Act 1998. You MUST bring
this form to the Registration Event.

To be completed by the person to be checked, please note ALL sections are compulsory
Title Mr/Mrs/Miss ______________________________ Surname_________________________________________
Forename_____________________________________ Middle name(s) ___________________________________
Previous surname(s) ___________________________ Previous forename(s) ______________________________
Home Telephone No.____________________________ Mobile Telephone No. _____________________________
Email address _________________________________________________________________________________________
Mother's maiden or family name _____________________________________________________________
Male Female
Town of Birth _________________________________ Country of Birth _________________________________
Type of Visa held (non UK citizens)________________ Visa expiry date (if applicable) _______________________

Dob (dd/mm/yy) / / National Insurance No.

Current address
Address Line 1____________________________________________________________________________
Address Line 2____________________________________________________________________________
Post Town ____________________________________ Country ______________________________________

Postcode Resident from (mm/yyyy) _________________________

Previous address history (if residence at current address is less than 5 years).
Use Additional Previous Address Form if necessary.
Address Line 1____________________________________________________________________________
Address Line 2____________________________________________________________________________
Post Town ____________________________________ Country ______________________________________

Postcode Resident from (mm/yyyy) _________________________

Address Line 1____________________________________________________________________________
Address Line 2____________________________________________________________________________
Post Town ____________________________________ Country ______________________________________

Postcode Resident from (mm/yyyy) _________________________

Bank/Building Society Account Details

Holders of Post Office Benefit accounts should be aware that Royal Mail is unable to make payments to
these accounts. Please provide details of an alternative Bank/Building Society account.
Name of Bank/Building Society ______________________________________________________________________
Bank/Building Society address __________________________________________________________________

Sort code (6 digits) Account number (8 digits)

Building Society Accounts only - Roll Number______________________________________________________

1
Health

Do you have any disability or health issues we need to be aware of? Yes ■ No ■
If yes, please ensure the details are fully explained in the Health Declaration.

Emergency Contact Details

Name ______________________________________ Relationship ____________________________________________________________

Address ______________________________________________________________________________________________________________

Town/City ________________________________________________ Post Code

Preferred contact number (please include dialling code) ________________________________________________________________
Alternative contact number (please include dialling code) ________________________________________________________________

Criminal Record

Have you ever been convicted of a criminal offence which is unspent? Yes ■ No ■

Do you have any impending prosecutions? Yes ■ No ■

Have you ever received a caution? Yes ■ No ■

If you have answered ‘yes’ to any of the above questions, please provide details below.

The nature of the offence __________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

The date of the conviction __________________________________________________________________________________________________

The sentence or court order ________________________________________________________________________________________________

The court where the case was heard ________________________________________________________________________________________

Your recent work, educational experience and non-work related activities

As part of your application for Christmas Casual employment within Royal Mail you are required to give details of your work,
educational experience and non-work related activities for the past 5 years, and if you were unemployed for a period of more than
4 months you must inform us of what you were doing in order to support yourself.
Please start with your most recent job first and include all jobs you have had including periods of self-employment. Include any
part-time work or vacation work; periods when you were not working (tell us what you were doing); periods of unemployment
(give us the address of your benefit office); time spent in the armed forces, school, college or university, or any voluntary/community
work. Please continue on a separate sheet, if necessary.
Note: You must account for the whole of the past 5 years. If there are any gaps or areas of concern, Royal Mail will not
be able to offer you casual employment, as we will not be able to fulfil our obligation to our postal licence.

From To Job title or what you Organisation name Contact Telephone

dd/mm/yyyy dd/mm/yyyy were doing and address name number

__________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

2
From To Job title or what you Organisation name Contact Telephone
dd/mm/yyyy dd/mm/yyyy were doing and address name number

__________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

NON EU STUDENTS DECLARATION ONLY (for completion by university/college representative)

Only complete this section if you intend to apply to work for over 20 hours per week.
I declare ____________________________________ is a full-time student of ________________________________________institution.
He/She will complete all educational obligations pre: Xmas vacation (e.g. lectures/examinations) on ____________________12.2007.
Signed ______________________________________________ Print Name ____________________________________________________
Position ______________________________________________ Department ____________________________________________________
Address ____________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________

Telephone No. ______________________________________

University/College authentication stamp:

APPLICATION DECLARATION
Before signing the form, please ensure you have completed ALL sections.
I give consent for the Royal Mail Group to carry out Criminal Record and Recruitment Risk Register and/or Voter Check(s)/Credit Reference
Check(s) as required for the position applied for. I agree for my personal data to be used by Royal Mail Group for the purpose of obtaining
a Disclosure Certificate through Disclosure Scotland. I understand this personal data will be exchanged electronically between these
forementioned parties. I give consent for the completed disclosure being returned to Royal Mail Group and for the disclosure to be opened
by Royal Mail Group. I understand that Royal Mail Group will keep my Disclosure Certificate for a period of 90 days.
I give consent for the Royal Mail Group to contact me by telephone if required.
I confirm that I am the person listed on this form and all the above details are true and complete.

Signed ______________________________________________________________________________Date ________________________

For use by Authorised Persons only

I confirm I have verified the identification of the above person and that the details are complete in order to work in Royal Mail Group or for
one of its Agents or subcontractors.

Signed _______________________________________________________________________________ Date ________________________

Print Name _____________________________________________________________________________ Tel No. ________________________
Company name and address________________________________________________________________________________________________
____________________________________________________________________________________________________________________

At Royal Mail we take equality and inclusion seriously and are proud to employ a rich and diverse mix of people. This is why we encourage and welcome applications from all parts of
the community, particularly women who are currently under-represented. We are positive about disability. Royal Mail is a trading name of Royal Mail Group. Registered number
4138203. Registered in England and Wales. Registered office: 148 Old Street, LONDON EC1V 9HQ.

3
 IN STRICTEST CONFIDENCE
Additional Previous Address Form
Please complete in black ink and write clearly in block capitals.
For use when the individual has lived at further addresses within the previous 5 years.

Title Mr/Mrs/Miss ______________________________ Surname_________________________________________

Forename_____________________________________

National Insurance Number

Previous address history

Address Line 1____________________________________________________________________________

Address Line 2 ____________________________________________________________________________

Post Town________________________________________________________________________________

Postcode Resident from (mm/yyyy) _____________________________________

Address Line 1____________________________________________________________________________

Address Line 2 ____________________________________________________________________________

Post Town________________________________________________________________________________

Postcode Resident from (mm/yyyy) _____________________________________

Address Line 1____________________________________________________________________________

Address Line 2 ____________________________________________________________________________

Post Town________________________________________________________________________________

Postcode Resident from (mm/yyyy) _____________________________________

Address Line 1____________________________________________________________________________

Address Line 2 ____________________________________________________________________________

Post Town________________________________________________________________________________

Postcode Resident from (mm/yyyy) _____________________________________

Signed____________________________________________________________ Date___________________________

At Royal Mail we take equality and inclusion seriously and are proud to employ a rich and diverse mix of people. This is
why we encourage and welcome applications from all parts of the community, particularly women who are currently
under-represented. We are positive about disability.
Royal Mail is a trading name of Royal Mail Group. Registered number 4138203. Registered in England and Wales.
Registered office: 148 Old Street, LONDON, EC1V 9HQ
4
 Your Health
As this form may be sent to our employee health service providers, Atos Origin, we do need to ask for your
personal details again.

Title Mr Mrs Miss Ms Other (please specify) _______________________________________

Surname ______________________________________________________________________________________
Forename(s) ___________________________________________________________________________________
Address _______________________________________________________________________________________

Town _______________________County ________________________Postcode

Contact Telephone Number(s) ____________________________________________________________________
Please answer the following questions as fully as possible. The information you give will be treated in
strictest confidence.
Date of birth (dd/mm/yy) / /
Please give your height and weight, without shoes cm/ft* kg/lb* (*delete as appropriate)
Please tick yes or no for the following Yes No
Do you have any current health problems? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Have you had any operations? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Have you had any major illnesses? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Have you been declined a job due to health problems, or been medically retired?. . . .
Are you taking any prescribed medication?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Are you having tests for any health condition? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Do you wear glasses or contact lenses? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Are you colour blind?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If you smoke, how many cigarettes per day? If you drink alcohol, how many units per week?
Have you had any problems with Yes No
Hearing? If yes, please tell us overleaf, how you communicate in an emergency . . . . . .
Recurring headaches or migraine? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Epilepsy or unexplained blackouts? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Hands, wrists, limbs, back, muscles or joints? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ruptures or hernias? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Psychological disorders, such as stress, anxiety, depression or mental illness? . . . . . . .
Heart, blood pressure or circulation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Breathing or chest conditions, such as asthma or bronchitis? . . . . . . . . . . . . . . . . . . . .
Digestive function, such as peptic ulcer, irritable bowel syndrome or indigestion? . . . .
Diabetes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A stroke? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Any serious head injury, such as a fractured skull or haemorrhage?. . . . . . . . . . . . . . .
If you have answered yes to any of the above questions, please provide further details, including dates
overleaf, and if applicable, let us know how many days from work or school you missed as a result. Please
continue on a separate sheet if necessary.
Yes No
Do you consider yourself disabled?
What is the nature of your disability? _____________________________________________________________
_________________________________________________________________________________________________
Please tell us below of any adverse effect your disability has on your ability to carry out normal day to day activities:
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________

Applicants for Night Shift Jobs only

Please let us know overleaf if you are aware of anything that may cause you problems while working on nights.

5
Your Health – additional details sheet
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________
Declaration
By signing below, I declare that to the best of my knowledge, the information I have given on this form is true and correct.
I understand that the information I have provided in this health declaration form may be released to your occupational health
service provider, Atos Origin. I also understand that Atos Origin may contact me by telephone – or request I attend an appointment
to assess my suitability for this specific job role – and will provide a report regarding my suitability to Royal Mail Group. I agree
that Atos Origin, if required, may contact my GP/Hospital Specialist for a report on my health.
Signed ____________________________________________________________ Date________________________________________

Your GP’s name and practice address, including postcode:

___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________ Telephone Number ___________________________

Hospital Specialist name and address, including postcode:

___________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________ Telephone Number ___________________________

For your information, personal data provided on this form will be held and used in accordance with the Data Provision Act 1998
and treated as confidential. This data may be verified by reference to information held by others.
Access to Medical Reports Act 1988
Under the terms of the above act you have the right to withhold your consent to Atos Origin to apply to your General Practitioner/Hospital Specialist for medical information.
If you give your consent you have the right to see the information in the report before it is sent to Atos Origin.
You have 21 days from the date of the letter notifying you that a report has been requested, in which to ask your General Practitioner/Hospital Specialist to let you see the report.
They will tell you if you cannot see any part of the report for professional medical reasons. If you are given access to the report your General Practitioner/Specialist will not send it to
Atos Origin until you give your consent.
If you regard any information in the report as incorrect or misleading you can ask, in writing, for it to be amended. (Please note, if your General Practitioner/Hospital Specialist does
not accept that the information is incorrect or misleading, they are not required to make any amendment, but in these cases they will invite you to prepare a written statement on the
disputed information, which will be attached to the report when it is sent to Atos Origin).
Subject to the provision of the Act, you have the right to see information about your medical condition for up to six months after it has been sent to Atos Origin. If your General
Practitioner/Hospital Specialist gives you a copy of the report, they may charge you a reasonable fee to cover the cost of supplying it.

With reference to the Access to Medical Reports Act 1988, I wish to see any such report before it is sent to Atos Origin. Yes No
6
 Information Checklist for your Assessment Day
YOU MUST BRING APPROPRIATE DOCUMENTS FROM THE 4 CATEGORIES BELOW.
Please remember to bring both the original and a photocopy of the documents from categories 1, 2 and 4, along with this
application pack.
Please ensure that all photocopies are complete and of a good, clear quality. For passports and travel documents, please copy the front
cover and all the pages that refer to information below.
CATEGORY 1, Proof of Identity and of Right to Work in the UK.
Choose ONE document from List A
A B
1) A United Kingdom (UK) passport describing the holder as a
British citizen or a citizen of the UK & Colonies having the right of
abode in the UK.
2) A passport containing a certificate of entitlement issued by, or
on behalf of the Government of the UK, certifying that the holder
has the right of abode in the UK.
3) A passport or national identity card issued by a State which is
a party to European Economic Area (EEA) agreement or any other
agreement forming part of the Communities’ Treaties which
confers right of entry to/residence in the UK, which describes the
holder as a national of a State which is a party to that agreement.
4) A UK Residence Permit issued to a national of a State which is
a party to EEA agreement or any other agreement forming part
of the Communities’ Treaties which confers right of entry
to/residence in the UK, which describes the holder as a national of
a State which is a party to that agreement.
5) A passport/other travel document or a residence document
issued by the Home Office which is endorsed to show that the
holder:
• has a current right of residence in the UK as the family member
of a named national of a State which is party to EEA agreement
or any other agreement forming part of the Communities’
Treaties conferring right of entry to/residence in the UK and who
is resident in the UK.
• is exempt from Immigration control and has indefinite leave to
enter/remain in the UK or has no time limit on their stay and the
passport containing the endorsement has not expired.
• has current leave to enter/remain in the UK and is permitted to
take the employment in question, providing it does not require
issue of a work permit.
6) A registration card, issued by the Home Office which confirms
that the candidate is permitted to take employment in the UK.
EEA member countries (other than the UK) are: Austria,
Belgium, Cyprus, *Czech Republic, Denmark, *Estonia, Finland,
France, Germany, Greece, *Hungary, Iceland, Ireland, Italy,
*Latvia, Liechtenstein, *Lithuania, Luxembourg, Malta,
Netherlands, Norway, *Poland, Portugal, *Slovakia, *Slovenia,
Spain, Sweden, Switzerland.
* = Accession States
OR TWO documents from List B
A document issued from a previous employer, Inland Revenue, the
Department for Work & Pensions (DWP), Jobcentre Plus, the
Employment Service, The Training and Employment Agency
(Northern Ireland) or the Northern Ireland Social Security Agency,
which contains the National Insurance number of the person
named in the document.
PLEASE NOTE: A document showing a handwritten or temporary
National Insurance number cannot be accepted. A temporary
number is made up of the letters TN, the employee’s date of birth
e.g. 01 01 50 and letter F or M to indicate gender.
The above document(s) must be accompanied with either of
the following documents.
A full birth/adoption certificate issued in the United Kingdom (UK)
which specifies the names of the holder’s parents.
PLEASE NOTE: A ‘short’ birth certificate without columns or
rows for parents’ details cannot be accepted unless it is from
the Republic of Ireland, Channel Islands or the Isle of Man.
(The local Registry Office which issued the original certificate can
issue full replacement Certificates on request.) or
A birth certificate issued in the Channel Islands, Isle of Man, or
Ireland. or
A certificate of registration or naturalisation as a British Citizen. or
A letter (containing an official Home Office stamp and letterhead)
issued by the Home Office, to the holder, which indicates that the
person named in it has:
• been granted indefinite leave to enter or remain in the UK. This
cannot be a SAL 1 or a SAL 2 (Standard Acknowledgement Letter).
• subsisting leave to enter/remain in the UK or is entitled to take
the employment in question in the UK. or
An Immigration Status Document issued by the Home Office, to
the holder:
• endorsed with a UK Residence Permit indicating that the holder
has been granted indefinite leave to enter/remain in the UK.
• endorsed with a UK Residence Permit which indicates that the
holder has been granted limited leave to enter/remain in the UK
and is entitled to take the employment in question in the UK.
If you give two documents from List B, which have different
names, you need to provide further documentation to explain
the reason for this e.g. marriage certificate, divorce
document, deed poll, adoption certificate or statutory
declaration.
7
CATEGORY 2, Proof of Residence; from any ONE of the following.
The document provided must: • Driving licence – if this is the new version, then either
A: Not be handwritten. section of the 2 part licence is acceptable.

B: Clearly display the candidate’s current name and address. • Tenancy Agreement – the agreement must have been
provided by either a Housing Association or Estate Agent
C: Contain identification (such as an official letterhead) from for it to be acceptable. We cannot accept private tenancy
a recognised organisation/business/government body. agreements between a private landlord and tenant.
D: Either have been issued within the last 12 months, or be • Letters from Governmental Bodies – such as Home
before a stated expiry date. Office, Inland Revenue, Social Service and National
E: Be original (i.e. not a photocopy). Health Service.
F: Not be issued by Royal Mail. • Television licence
Please see below a list of ideal documents which although not • Student letters – confirming place on course or receipt of
exhaustive, lists documents which, providing that they comply payment for fees.
with points A-F above, would be acceptable: • Letter with an official letterhead – from a professional
• Bank letters/statements – do not copy bank cards. body such as Solicitors, Accountants, and Estate Agents.
• Utility bills – they do not have to have been paid.

CATEGORY 3, Your completed Application containing the following information.

NB – All of these forms are available to print in the Interview • Fully completed, signed and dated health form.
Zone once you have booked your assessment slot. • One recent Passport-sized photograph.

CATEGORY 4, Non EEA Students ONLY.

You must bring with you an original document demonstrating • Be issued by the educational institution where the learning
that you have been accepted for a course of study at: is to take place and clearly indicate the place of study.
• A publicly funded institution of further or higher education; or • If you wish to work more than 20 hours per week, you must
• A bona fide private education institution which maintains complete the section on page 3 of the registration form and have
satisfactory records of enrolment and attendance; or it authorised by your university or college. It must state the date
you have completed your terms studies (i.e. lectures or exams)
• An independent fee paying school outside the maintained sector. before the Christmas vacation, and give the contact details of
The documentation provided must: your university/college representative, such as your tutor.
• Be original. • NOTE: University/college offerletters are NOT acceptable.

TO NOTE - IF YOU DO NOT BRING ALL THE REQUIRED DOCUMENTATION, THEN YOU WILL NOT
BE INTERVIEWED.
Please remember you are required to bring both the original and a photocopy of the documents from categories 1, 2 and 4.
The information that we request is essential for us if we are to proceed with your application. As we value your application we
have provided a checklist to help you gather the information requested.

Category Document(s) Tick Box

1. Proof of right to work in UK.
2. Proof of residence.
3. Completed Application details. One recent Passport-sized photograph
Christmas Casual Registration and
Security Checks Consent Form
Health Form
4. Proof of student status Evidence of Enrolment (if appropriate)
(if non EU student).

REMEMBER - If you do not bring the required documents, you will be turned away from the interview. Once you have
collated all the above documents, you may then re-apply for another vacancy.

At Royal Mail we take equality and inclusion seriously and are proud to employ a rich and diverse mix of people. This is why we encourage and
welcome applications from all parts of the community, particularly women who are currently under-represented. We are positive about disability.
Royal Mail is a trading name of Royal Mail Group. Registered number 4138203. Registered in England and Wales.
Registered office: 148 Old Street, LONDON EC1V 9HQ.