Application Form

Position Applied For Where Did you hear about this post?
If recommended by Cyberspace IT employee please state their namen
Personnel Information Your Name (required) Email Address (required) Phone Number (required) Street Address (required) City (required) State or Province (required) Your Resume (required) Your Proof of Identity (required) Your Proof of Address (last 3 months) (required)

Please Provide a 5-year Work Employment History, if 5-year is not applicable please use quote N/A in the fields Company Name 1 (required) Company Address Address (required) City (required) State or Province (required) Line Manager Email (required) Position (required) Company Name 2 (required) Company Address Address (required) City (required) State or Province (required) Line Manager Email (required) Position (required) Company Name 3 (required) Company Address Address (required) City (required) State or Province (required) Line Manager Email (required) Position (required) Company Name 4 (required) Company Address Address (required) City (required) State or Province (required) Line Manager Email (required) Position (required)

Self-Employment History Name 1 (required) Company Address Address (required) City (required) State or Province (required) Name 2 (required) Company Address Address (required) City (required) State or Province (required)

Criminality, Offences, Cautions & Convictions Have you ever been fined, received a caution, sentenced to imprisonment, placed on probation, discharged on payment of costs, or had any order made against you by a criminal, civil or military court or public authority? YesNo Have you ever been convicted, fined or had any order made against you by a criminal, civil or military court outside the United Kingdom? YesNoN/A Have you ever been convicted, fined or had any order made against you by a criminal, civil or military court outside the United States? YesNoN/A Are there any alleged offences outstanding against you? YesNo If you have answered YES to any of the questions above, please give details Further Information
Disclosure is not required where there is a sentence to which the Rehabilitation of Offenders Act 1974 applies. Failure to disclose an unspent sentence may result in summary dismissal. NOTE: All applicants are subject to vetting/screening and may also be required to obtain records of any convictions from the Police under the Subject Access provisions of the Data Protection Act or Disclosure from The Criminal Records Bureau.

Financial History Have you any outstanding attachments to earnings? YesNo Do you have a bankruptcy order or any voluntary arrangements? YesNo Are you the subject of any County Court Proceedings (CCJs)? YesNo If you have answered YES to any of the questions above, please give details Further Information

Additional Information Page Further Information

Declaration Please read carefully before signing this application. I certify that to the best of my knowledge, the details and information given in this form are complete and correct. I understand that to make a false statement to the Company or its representatives will give the Company the right to terminate my employment immediately and without notice. I understand that referencing will only take place if I have received a written offer of employment and that if an unsatisfactory reference is received or referencing is unable to be completed within the given time then the Company may terminate my offer of employment. I understand that employment or other work with the Company is subject to satisfactory vetting in accordance with the Code of Practice for BS 7858 and I undertake to co-operate with the Company in providing any information required to meet this criterion. I authorise the Company and/or its nominated agent to approach previous employers, education bodies, referees or government agencies to verify that the information I have provided is correct and complete. I give the Company permission to collect, retain and process information about me in connection with my employment and in accordance with the Data Protection Act and I understand that this will be held on a computer and some or all will be held in manual records. You may occasionally provide information about me to a third party. I agree that I will, when required by the Company, apply for Enforced Subject Access for information (if any) relating to me on nationally held police computers and provide the results of that enquiry to the Company in confidence, or alternatively obtain disclosure from The Criminal Records Bureau. I agree to adhere to any regulated industry requirements appropriate to the role applied for. e.g. ISA (Independent Safeguarding Authority). I understand that the Company reserves the right to require me to undergo a medical examination or a health assessment at the Company’s expense. I understand that if I wish to take a second job whilst working for Cyberspace IT, I am required to contact the Human Resources Department for authorisation. I authorise the Company to make a consumer information search with a credit reference agency and to keep a record of that search and may share that information with other credit reference agencies.

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Cyberspace IT t/a CP Holdings, Limited is a limited company registered in England Reg No: 14254426 Vat No: GB 446 2046 09
Registered Office: 86-90 Paul Street, London, Greater London, United Kingdom, EC2A 4NE

Cyberspace IT t/a CP Holdings, LLC is a Limited Liability Coporation company registered in Florida EIN No: 61-2083558
Registered Office: 7901 4th St N, Ste 14023, St Petersburg, Florida, 33702

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