Page 1 of 2

Door Supervisor Application Form

Company: Stag Security Limited
Estimated completion time: 10-15 minutes

SECTION 1 - Personal & Contact Details

Purpose: Identity verification, communication, and records.

Full Legal Name (as per SIA licence)

Preferred Name (if different)

Date of Birth

Current Address

Address History (last 5 years)

Please include dates and postcodes

Mobile Number

Email Address

National Insurance Number

Right to Work in the UK

Right to Work in the UK
A
B
C

If Visa/Work Permit, provide details and expiry date

SECTION 2 - SIA Licensing & Compliance

Purpose: Legal compliance and deployment eligibility.

SIA Licence

Licence Type

Licence Type
A
B

Licence Expiry Date

Upload SIA Licence (Front & Back)

Clear photos required

Have you ever had an SIA licence suspended or revoked?

Have you ever had an SIA licence suspended or revoked?
A
B

If yes, please provide details

Show only if Yes selected above

SECTION 3 - Training & Qualifications

Purpose: Deployment suitability and client requirements.

Door Supervisor Training Provider

Date of Qualification

Emergency First aid at Work (EFAW)

Emergency First aid at Work (EFAW)
A
B

EFAW Expiry Date

ACT/ACT Awareness Trained?

ACT/ACT Awareness Trained?
A
B

Conflict Management Training Completed?

Conflict Management Training Completed?
A
B

Physical Intervention Training Completed?

Physical Intervention Training Completed?
A
B

Additional Qualifications

e.g. CCTV, NVQ, HECPO, HEFAT, HEAT, supervisory roles.

SECTION 4 - Experience & Availability

Purpose: Matching staff to contracts and rotas.

How long have you worked as a Door Supervisor?

Previous Security Companies (Last 5 Years)

Types of Venues Worked

Types of Venues Worked
A
B
C
D
E

Comfortable Working Nights?

Comfortable Working Nights?
A
B

Comfortable Working Weekends?

Comfortable Working Weekends?
A
B

Comfortable Working Bank Holidays?

Comfortable Working Bank Holidays?
A
B

Preferred Working Areas (Towns/Cities)

SECTION 5 - Conduct, Professionalism & Risk Screening

Purpose: Risk Management and client confidence.

Have you ever been dismissed from a security role?

Have you ever been dismissed from a security role?
A
B

Have you ever been subject to a disciplinary investigation?

Have you ever been subject to a disciplinary investigation?
A
B

Do you have any unspent criminal convictions?

This will not automatically exclude you. All disclosures are handled confidentially in line with SIA guidance.
Do you have any unspent criminal convictions?
A
B

Are you currently under investigation for any offence?

Are you currently under investigation for any offence?
A
B

SECTION 6 - Physical & Medical Declaration

Purpose: Fitness for a role without discrimination.

Do you have any medical conditions that may affect your ability to perform the role safely?

Do you have any medical conditions that may affect your ability to perform the role safely?
A
B

Are you able to stand for long periods?

Are you able to stand for long periods?
A
B

Are you able to respond to physical incidents if required?

Are you able to respond to physical incidents if required?
A
B

Do you require any reasonable adjustments?

SECTION 7 - Uniform, Equipment & Appearance

Purpose: Brand standards and deployment readiness

Polo Size

Jacket Size

Willing to comply with company grooming and uniform standards?

Willing to comply with company grooming and uniform standards?
A
B

SECTION 8 - References

Purpose: Due diligence.

Reference 1

Name, Company Role, Contact Details.

Reference 2

Name, Company Role, Contact Details.

May we contact these references?

May we contact these references?
A
B

SECTION 9 - Declarations & Consent

(Final Section - Mandatory)

Declaration

Declaration

Consent

Application data will be retained for up to 12 months for recruitment purpose unless otherwise required by law.
Consent

Signature (Typed Name)

Date