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Application

Please complete the form below as part of your application process

Information

Business Name*

Primary Contact Name*

Middle name

Surname*

Email Address*

Business Address Line*

City*

Postcode*

Contact number*

Company Registration No.

Area of Expertise*

Other

Do you provide 24 hour Emergency Call Out Service?*

Yes

Health & Safety

Does your company hold any health and safety accreditations?

Have you had any major non-compliances or safety breaches in the past 5 years?*

Yes

If yes, please provide details*

Have you ever been removed from a contract or accreditation scheme due to non-compliance?*

Yes

If yes, please provide details*

Are you familiar with the RIDDOR regulations and their requirements?*

Yes

Has training been provided to your employees on all of the above requirements?*

Yes

N/A

Checklist & Attachments

Public Liability Insurance Certificate*

Employer's Liability Insurance Certificate*

Relevant Qualifications/Accreditations*

Public Liability Insurance Certificate *

Employer's Liability Insurance Certificate *

Relevant Qualifications/Accreditations *

Signature *

Date*

Thank you for completing your application. GSC may reach out if we have any questions or need further information. We'll be in touch soon with an update on your application.

GSC Agency

Contact our team 02034 557 557 contact@gscagency.co.uk

Find us here

Cotswold House, 219 Marsh Wall, Canary Wharf, London, E14 9FJ

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