Applications - Recruiting Solutions (East Midlands) Ltd

About You

First Name(s) Surname

Sex

MaleFemale Date of Birth Address

Postcode Telephone No.

Email Address National Insurance Number

Would you like to work:

Full TimePart TimeEvenings & Weekends

Do you have your own transport?

YesNo

Click to upload your proof of ID

Work Experience

Start Date: End Date:

Company Name and Address: Job Description Reason for Leaving

Start Date: End Date:

Company Name and Address: Job Description Reason for Leaving

Qualifications

Vehicle Licenses

Car LicenseFLT CounterbalanceFLT ReachHGV Class 1HGV Class 2PCV LicenseOther

Your Health

Have you:

Had any major illnesses in the last 5 yearsHad any major operations in the last 5 yearsAny medical condition which requires daily medicationAny condition which may effect your work

Absence

Approximately how many days have you taken absent in the last year? Is there any reason other than medical that we might expect absence leave to be taken?

Disability

Do you have, or have you had a disability?

YesNo

Are you registered disabled?

YesNo

Please give details

Further Information

Have you been convicted of any criminal offence?

YesNo

Any prosecutions pending

YesNo

If yes to any of the above please give details

References

Please provide us with two character or work related referees.

Name: Address: Tel No. Relationship

Emergency Contact

In case of emergency please provide us with an emergency contact:

Name: Address: Tel No. Relationship

General Data Protection Regulation (GDPR)

I confirm that I have received a copy of the GDPR privacy Policy 2018.

Yes

Declaration

I confirm that the information provided is correct to the best of my knowledge and that I am the above person. I am legally able to seek work within the UK and that the documents I have provided are legal. I give my permission to pass on my personal data to potential employers and third party recruiters.

Yes

Apply to work with us today

About You

Work Experience

Vehicle Licenses

Your Health

Absence

Disability

Further Information

References

Emergency Contact

General Data Protection Regulation (GDPR)

Declaration