Assessment Day form

Personal Information

Full Name

First

Last

Address

Zip/Postal

City

Country

Home Phone

Mobile Phone

Date of birth

National Insurance Number

Emergency Contact

Name of Contact

First

Last

Relationship to you

Address

Zip/Postal

City

Country

Home Phone

Mobile Phone

Other

Do you currently have holidays booked?

Yes

Please specify your dates

Do you have any health conditions that e-cargobikes.com should be made aware of?

Yes

Please specify

Do you have any ‘unspent’ criminal convictions?

Yes

Have you had a Disclosure and Barring Service (DBS) check in the last year?

Yes

If you are successful in this application we will request you apply for a basic Disclosure and Barring Service (DBS) check to get a copy of your criminal record. It’s available for people living or working in England and Wales. The check will only show convictions that are not ‘spent’, for example some types of caution will disappear after 3 months.

Right To Work (if not a UK citizen)

Please either enter your Share Code or upload clear pictures of the front and back of your Right To Work Card.

Share Code

Right To Work Card front

Maximum upload size: 5MB

Please upload a clear picture of the front of your Right To Work Card

Right To Work Card back

Maximum upload size: 5MB

Please upload a clear picture of the back of your Right To Work Card

Personal Information

Emergency Contact

Other

Right To Work (if not a UK citizen)

Availability