LP Training Solutions Apprentice Information Apprentice SQEP Draft Apprentice SQEP Form Draft Step 1 of 7 – Personal Details 14% Name* Forenames Surname HiddenDate of Birth* MM slash DD slash YYYY Home Address* Street Address Address Line 2 City County Postcode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email Address*(If you do not have an email address please type N/A in the text box.) Home Phone Number*(If you do not have an home phone / landline number please type N/A in the text box) Mobile Phone Number*(If you do not have an mobile phone number please type N/A in the text box.) National Insurance Number.* Driving License?*–YesNoCar Owner?*–YesNoOVERALL SIZES (PPE):* SHOE SIZE:* Next of KinPlease provide the details of who to contact in case of emergencyNext of Kin Name* Forenames Surname Relationship to you (the worker)* Next of Kin AddressLeave blank if same as your home address Street Address Address Line 2 City County Postcode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Next of Kin (Emergency) Phone Number* Next of Kin Email Address*(If you do not have an email address please type N/A in the text box.) Qualification DeclarationWhat is Your Trade or Skill*e.g. Fitter, Electrician, Industrial Operative. WARNING – Failure to provide an accurate declaration of qualifications may result in disciplinary action. All candidates must rake original certificates with them to the first day of site induction. QUALIFICATIONS/CERTIFICATES/SAFETY CARDS DECLARATION*QUALIFICATIONS/CERTIFICATES/SAFETY CARDSAWARDING BODYISSUE DATEEXPIRY DATECAN A COPY BE PROVIDED (YES/NO) (To add additional qualifications please click the plus button on the right).Please provide approx. number of years experience for the qualifications listed above.*QUALIFICATIONSApproximate number of years experienceCAN A COPY BE PROVIDED (YES/NO) (To add additional qualifications please click the plus button on the right)If you need any additional space to put down your qualifications use the space below.Please state any NVQs you hold and at what level-Have you worked on a HS2 site before? If so please state where and what inductions have you attended. EMPLOYMENT RECORD (MOST RECENT FIRST)*START DATEEND DATEEMPLOYERDETAILS OF WORK UNDERTAKEN AND PROJECTS WORKED ONCONTACT NAME, TEL NO & EMAIL (To add additional employment records please click the plus button on the right) Civil and Ground Worker Experience:Do you have any civils or ground work experience? PIPE LAYING AND DRAINAGE DEEP DRAINAGE KERB LAYNG CONCRETE POURING AND PLACING CONCRETE FINISHING If you answered yes to any of the above please elaborate below*Specific experienceNVQ?Please state approximate number of years experience below:Experience & Additional Comments REFERENCES: – PLEASE PROVIDE THREE WORKING REFERENCESLP TRAINING SERVICES POLICY STATES THAT ALL EMPLOYEES MUST PROVIDE A MINIMUM OF 3 WORK REFERENCES.*Company NameAddressContact and PositionEMAIL / TEL NO. *Company NameAddressContact and PositionEMAIL / TEL NO. *Company NameAddressContact and PositionEMAIL / TEL NO. SQEP Health Assessment 2021Name* Forenames Surname Do you suffer from the following: Diabetes Asthma or any other respiratory problems Back trouble of any description? Arthritis Epilepsy/fits/blackouts at any time Head Injury Dermatitis or any other skin disease Heart Trouble Strains/Sprains injury or a weakness of the joints Dyslexia Eye or Ear Trouble Any other Disease or Illness not mentioned above None of the above If you answered yes to any of the above please provide further details below:-Do you know of any health factors, physical or otherwise that may prevent you from undertaking any apprenticeship work with LP Training Services?*Are you currently taking any medication?–YesNoIf you selected yes, please specify:Have you ever failed a drugs and alcohol test for a previous employer?–YesNoIf you selected yes, please provide further details:The above answers are true and correct to the best of my knowledge.Sign* Print Name* Date* MM slash DD slash YYYY LP Training Services – Policies and ProceduresThe following policies have been briefed to you as part of your induction, these will also be emailed to you for your records, please tick/check to confirm you have understood the policies, procedures and instruction given to you by LP Training Services.* LPS – Absence and Sick Pay Policy Procedure LPS – Alcohol and Drugs Abuse Policy Procedure LPS – Data Protection Policy Procedure LPS – Disciplinary Policy Procedure LPS – Holiday Form LPS – Lodge Form LPS Lodge Procedure LPS – Right of Search Policy Procedure LPS – Right to Work Policy Procedure LPS – Staff Handbook LPS – Whistleblowing Policy Procedure Policies and Procedures Agreement* I acknowledge that I have read and understood the linked LP Training Services Policies and Procedures in their entirety, and agree to be bound by terms to abide by them for the duration of my apprenticeship with LP Training Services.Diversity Monitoring FormLP Training Services will treat everyone equally irrespective of sex, sexual orientation, gender reassignment, marital or civil partnership status, age, disability, colour, race, nationality, ethnic or national origin, religion or belief, political beliefs or membership or non-membership of a Trade Union or spent convictions.Which ethnic group do you most identify with?* e. g. British If you would prefer not to say please state so.What is your religion or belief?* e. g. Protestant If you would prefer not to say please state so.DisabilityA disabled person is defined in the Disability Discrimination Act as someone with a physical or mental impairment that has a substantial and long term impact on their ability to carry out day to day activities. This includes progressive and long term conditions from the point of diagnosis such as HIV, Multiple Sclerosis or cancer. a) Having read the definition above, do you consider yourself to be disabled?*–YesNoPrefer not to sayb) If you answered yes, can you please indicate the day to day activities affected by your disability. (Tick as many as applicable) Eyesight Hearing Speech Mobility Progressive condition Manual Dexterity Physical coordination Ability to learn or understand, or memory Ability to lift, carry or move everyday objects If you wish, please state your disability here: We will try to provide access, equipment or other practical support to people with disabilities. Permission to work in the UK Do you have immigration permission to work in the UK?–YesNoIn line with UKBA guidance on the prevention of illegal working we will need to verify and take a copy of your original ID documentation as evidence of your right to work in the UK if you are to be engaged by LP Training Services for temporary work.DeclarationI understand that the information I have provided above will be recorded and processed by HR manually and/or electronically in accordance with the Data Protection Act 1998 and the data protection principles contained therein. Name* Forenames Surname Signed* Date* MM slash DD slash YYYY Criminal Convictions Declaration FormHave you ever been convicted of a criminal offence?*–YesNoDo you have a court appearance pending or have you been charged by the Police for a criminal offence?*–YesNoIf you answered YES to A or B above, please supply the following detailsDateCourtDetails Of OffenceSentence I agree to the below statementI CERTIFY THAT:I have read the Guidance Notes overleaf and have not withheld information that may affect my application for appointment. I understand that false information or omissions may lead to dismissal. The information supplied above may be verified by Logical.Data Protection Act 1998I consent to the information which I have provided on this form being used by the Human Resources Managers in the decision making process which may include requesting a criminal records check for certain posts. If you are appointed to a post, this form is resealed in an envelope and filed in your personal file. If you are unsuccessful, the form will be retained in a sealed envelope, with the papers relating to the vacancy and kept for 6 months before being destroyed. For more information on the Rehabilitation of Offenders Act 1974 please follow the link.Date* MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.