Your Details

Name

Phone

Applying for fire station

Address

Address 2

Town / City

Post Code

How did you find out about the role?

Other

National Insurance number

Please enter your National Insurance Number (NI Number) below. This should consist of nine characters: two letters followed by six digits and then a letter, e.g. AB 12 34 56 C. Note that this number will be checked at a later stage in the process to verify your identity.

Eligibility to work in UK *

Yes

Shoe Size (UK)

To ensure we have enough approximately sized boots for applicants to wear at the Firefighter selection tests, please state your nearest shoe size (UK sizing).

Are you a current serving firefighter or ever served as a Firefighter in UK before *

Yes

Time to travel from home to Fire Station

When traveling at normal road speeds and adhering to rule imposed under the Road Traffic Act and other legislation, how long wold it take in minutes for you to travel to the Fire Station from home.

Time to travel from your place of work to Fire Station

When traveling at normal road speeds and adhering to rule imposed under the Road Traffic Act and other legislation, how long wold it take in minutes for you to travel to the Fire Station from work.

Mode of transport

Will your main employer release you to attend emergency calls whilst at work? *

Yes

Current Employer

Please complete the following section providing details of your current or most recent employment

Employer 1 Name

Employer 1 Date appointed

Employer 1 Address

Employer 1 Current employer *

Yes

Employer 1 Summary of responsibilities

Previous Employers

Employer 2 Name

Employer 2 Date appointed

Employer 2 Address

Employer 2 Current employer *

Yes

Employer 2 Summary of responsibilities

Employer 3 Name

Employer 3 Date appointed

Employer 3 Address

Employer 3 Current employer *

Yes

Employer 3 Summary of responsibilities

Contact details for references

Please provide the names and contact details of two referees (one of whom should be your present or most recent employer). If you are unable to provide details of referees, please contact the On-Call Support on 01482 567540.

Reference 1 Name

Reference 1 Phone

Reference 1 Address

Reference 1 Contact before interview *

Yes

Reference 1 Email

Reference 2 Name

Reference 2 Phone

Reference 2 Address

Reference 2 Contact before interview *

Yes

Reference 2 Email

Driving Time Regulations

( tick all that apply)

I do not do any driving of goods or passenger vehicles as part of my main employment

I am a self-employed driver

My employment is as a driver of a goods or passenger vehicle

I am a mobile worker as defined by the legislation

Further details

The type of vehicle I drive is:

In excess of 3.5 tonnes

Carries more than 8 passengers / more than 9 seats

Less than 3.5 tonnes

Carries less than 8 passengers / less than 9 seats

Statement

I have read and fully understand the duty on me to comply at all times with the relevant legislation on drivers’ hours and rest breaks. I confirm that the above details are correct at the time of completion and if I am successful in this application any changes in my employment that involves driving encompassed by these or future Regulations will be immediately notified to the On-Call Hub and my Watch Manager. If I am successful in this application I understand that any changes in my employment or duties undertaken in relation to driving (including being a mobile worker) will need to be considered by Humberside Fire and Rescue Service in relation to my contract of employment. In agreeing below I confirm my understanding that Humberside Fire and Rescue Service reserve the right to contact my main employer to discuss my employment in relation to relevant Regulations.

Statement agree

Declaration of Offences

You are required to declare any previous convictions for offences under the Rehabilitation of Offenders Act 1974. Include offences dealt with by a court of law, HM Services disciplinary procedures and any driving offences. Please note that we will apply for an enhanced Disclosure and Barring Service check as part of your application.

Do you have any previous criminal convictions spent or unspent or are you at present subject to criminal charges which you should disclose? *

Yes

If Yes, please give details (Offence, sentence, dates etc.):

Equality Act 2010

Where required or identified, we will consider what reasonable adjustments could be made to enable you to proceed with your application, provided any such adjustments do not contravene Health and Safety Legislation.

Do you have a disability or feel that you have a specific need that you wish to be taken into consideration? *

Yes

If Yes, please provide further details

Equal Opportunities

The Fire and Rescue Services recognise the value of having a diverse workforce. In order to ensure that our recruitment advertisements attract people from all groups within the community, we would be grateful if you would answer the following questions. This information is confidential and will be used solely for monitoring purposes.

Gender

Gender Identity

Gender Identity (Other)

Ethnic Origin

Religion

First Language

Sexual Orientation

Disability

Age

Our Commitment to you: We understand that in some cases additional support may be needed to enable a candidate to participate fully in the Selection Process (e.g. Dyslexia). Please record any support requirements that you may have in the space below. This information enables us to ensure that the necessary arrangements are made on your behalf. This detail is kept confidential and has no bearing on a selection decision.

Additional Support

Working Time Directive Opt-out Form

Holiday Pay Calculation - to Opt-out of the Working Time Regulations

Waiver to opt-out of the Working Time Regulations Holiday Pay calculation based on my average earnings over the 12 weeks immediately before the start of requested leave taken.

I hereby confirm that I am content for my Holiday Pay to be calculated in line with the National Joint Council’s recommendation that my average earnings be calculated annually in December based upon the previous 12 months and that the resulting figure be used for any annual leave I take in the following year.

I also understand that I can terminate the agreement after giving 30 days' notice of my intention to do so.

Working Time Directive opt out agree

Our Ethical Principles and Behaviours

Putting our Communities first - we put the interests of the public, the community, and service users first.
Integrity - we act with integrity including being open, honest, and consistent in everything that we do.
Leadership - we are all positive role models, always demonstrating flexible and resilient leadership. We are all accountable for our behaviour, decisions, and actions, and challenge all behaviour that falls short of the highest standards.
Dignity and respect - we treat people with dignity and respect, making decisions objectively based on evidence, without discrimination or bias.
Equality, diversity, and inclusion (EDI) - we continually recognise and promote the value of EDI, both within FRSs and the wider communities in which we serve. We stand against all forms of discrimination, create equal opportunities, promote equality, foster good relations, and celebrate difference.

I agree

I have read and understood the Ethical Principles and Behaviours of Humberside Fire and Rescue Service and will commit to practice and actively promote them.

I understand that Humberside Fire and Rescue Service reserves the right to verify claims made in this application. I agree to Humberside Fire and Rescue Service collecting, retaining and processing personal information on this application form in connection with any proposed employment and to monitor the Service’s compliance with the law and best practice in terms of equal opportunity and non-discrimination under Data Protection Rules. We will never pass your details to any third party without your consent. Our Privacy Policy can be viewed here.

A red asterisk (*) means a required field

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