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Your Employee Background Form
Welcome to Salvere Support
Please enable JavaScript in your browser to complete this form.
Customer Name
*
First
Last
The name of the person receiving support from the PA
Employee Details
A copy will also be sent to your email address.
PA Name
*
First
Last
Address
*
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Phone
*
Email
A copy of the form will also go to this email address.
Date of Birth
*
To select date of birth click/tap the box above. Tap click "Month" at top and select. Then tap year and enter birth year or scroll to find your year of birth.
Gender
*
Please state how you would like your gender to be referred to or state "prefer not to say".
Employment History
Please provide details of all employment and explain any gaps in employment in the relevant section below. Add more past employers as appropriate. If this is your first job and there is no employment history, please select "No previous employment" below.
Employment History Status
*
Previous employment
No previous employment
Please select ONE option.
Employer Name
Employer email
Position Held
Start Date
End Date
Reason for Leaving
Add more past employers (if required)
Second Employer
Third Employer
Fourth Employer
Fifth Employer
Sixth Employer
Tick the box to add the employer.
Second Employer Name
Employer email
Position Held
Start Date
End Date
Reason for Leaving
Third Employer Name
Employer email
Position Held
Start Date
End Date
Reason for Leaving
Fourth Employer Name
Employer email
Position Held
Start Date
End Date
Reason for Leaving
Fifth Employer Name
Employer email
Position Held
Start Date
End Date
Reason for Leaving
Sixth Employer Name
Employer email
Position Held
Start Date
End Date
Reason for Leaving
Please explain any gaps between end of one employment and the start of the next in your employment history
Additional Information
Do you require any adjustments at work to support you to carry out your duties effectively and safely?
*
Yes
No
Please provide brief details:
You may be asked to complete a more detailed health questionnaire.
References
*
I am willing to supply two references
I am unable to supply two references
Salvere requires details of two references for all PAs. One of the references must be the current employer if you are transferring under TUPE or the most recent employer, if unemployed. If you have not been previously employed, both references can be character references.
Please provide details about the difficulty in obtaining two references:
Confirmations (tick all that apply)
*
I hold a clean driving licence
I have access to my own car and I am willing to use it for work purposes
I am willing to have a Disclosure and Barring Check (DBS)
I have a live DBS which is on the DBS Update Service
I have the right to work in the UK
None of the above
Please note that foreign nationals with a right to work in the UK, must supply their date of birth and share code.
Please check your responses and click the submit button below.
Submit
