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Registration Form

Step 1 of 6 - Personal Details

Registration Form

Rotherwood Recruitment is committed to a policy of equal opportunities for all work seekers and shall adhere to such a policy at all times and will review on an on-going basis on all aspects of recruitment to avoid unlawful or undesirable discrimination. We 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 and we place an obligation upon all staff to respect and act in accordance with the policy.

Rotherwood Recruitment shall not discriminate unlawfully when deciding which candidate/temporary worker is submitted for a vacancy or assignment, or in any terms of employment or terms of engagement for temporary workers. Rotherwood Recruitment will ensure that each candidate is assessed only in accordance with the candidate’s merits, qualification and ability to perform the relevant duties required by the particular vacancy.

Today’s date

DD slash MM slash YYYY

Which branch are you registering with?(Required)

Keighley

Burnley

Which job or sector are you interested in?

Personal Details

Name

Title First Middle Last

Eligibility to work in the UK

Before introducing you to a company the agency must confirm your identity and right to work in the UK by providing a passport or birth certificate and/or visa/share code.

Nationality

Please state your nationality

Are you eligible to work in the UK?

Yes

What document supports your eligibility?

(Please upload a copy at the end of the form)

UK/Irish Passport

Visa

Share Code

Contact Details

Address

Address Address Line 2 Town Post Code

Your Email Address

Contact Number(Required)

Work Details

What job role are you seeking?

What type of work are you looking for?

Temporary

Temp to Perm

Permanent

Anything

What days are you wanting to work?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Hours of work?

Full time

Part time

Shifts

Nights

Are you flexible on the hours/days?

Yes

Do you have any PPE?

Yes

Please list your PPE:

How do you travel to work?

Own car

Public transport

Licences – do you have any FLT?

Yes

Please list:

Criminal Convictions

Before completing this section please read our policy regarding candidates with criminal convictions found under policies on this website.

We are asking you to complete this form in relation to job roles which are not exempt from the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (2013 and 2020). For this reason you are only required to disclose information about unspent convictions. You are not required to disclose spent convictions on this form.

We will seek to put forward/supply the best possible candidates to our clients. Having a criminal conviction will not necessarily exclude you from the process.

Do you have any unspent criminal convictions?(Required)

Yes

Please provide the offence dates, dates of conviction/caution, offence types and sentences:

The information given will be treated in the strictest of confidence and only taken into account where, in our reasonable opinion, the offence is relevant to the post to which you are applying. Failure to declare a conviction may require us to exclude you from our register if the offence is not declared but later comes to light. If you are working in an assignment with a client at the time that we are made aware of a conviction that have not disclosed to us, we may be legally required to inform our client of that information and your assignment may be terminated.

Health and Disability

We want to ensure that we provide work finding services to all work seekers fairly and equally. If a permanent role or temporary assignment requires an intrinsic* function to be completed, we will discuss your ability to undertake this function after you have been successfully registered with the Agency.

* Intrinsic means if that particular task could not be performed the job could not be carried out.

Do you have any disability or health issues?

Yes

If you have a disability, what are your needs in terms of reasonable adjustments in order to access this recruitment service and to attend interview, or to take aptitude tests etc?

Do you have any disability or health issues that may make it difficult for you to carry out functions which are intrinsic to the role you seek?

Work History

Please list your previous employers, the dates you worked and the position you held

Employer 1

Employer Name

Employer Address

Position held

Employed from:

MM slash DD slash YYYY

To:

MM slash DD slash YYYY

Reason for leaving

Referee Name

Position

Contact Number

Contact Email

Permission to contact(Required)

Yes

Add new employer?(Required)

Yes

Employer 2

Employer Name

Employer Address

Position held

Employed from:

MM slash DD slash YYYY

Employed to:

MM slash DD slash YYYY

Referee Name

Position

Contact Number

Contact Email

Permission to contact(Required)

Yes

Add new employer?(Required)

Yes

Employer 3

Employer Name

Employer Address

Position held

Employed from:

MM slash DD slash YYYY

Employed to:

MM slash DD slash YYYY

Referee Name

Position

Contact Number

Contact Email

Permission to contact(Required)

Yes

Self Evaluation

Please tick which 6 statements relate to you the most (be honest!)

Flexible

Organised

Attention to detail

Realistic

Committed

Problem Solver

Night Owl

Morning Bird

Determined

Good with numbers

Computer whiz

Team Player

Likes working alone

Patient

Accurate

Reliable

Day Dreamer

Multi-lingual

Articulate

Proud

Payment Information

NI Number

Date of Birth

MM slash DD slash YYYY

Gender

For temporary or supply workers, we will need bank details once your application is verified.

Additional Information

Have you ever registered with Rotherwood before?

Yes

When?

Additional information to take into consideration

Data Protection Statement

Rotherwood Recruitment provides work-finding services to its clients and work-seekers. We must process personal data (including sensitive personal data) so that we can provide these services – in doing so, we act as a data controller. This is why we have asked for your personal data on this form.

When we process your personal data we must do so in accordance with data protection laws. Those laws require us to give you a Privacy Statement to explain how we manage your personal data which is available here.

Declaration and Consent of Personal Information(Required)

I confirm that the information I have given herein is true and correct.

I understand that the service that the service provided by Rotherwood will incur no cost to myself. If, during the course of a temporary assignment, the client wishes to employ me direct that Rotherwood will be entitled either to charge the client an introduction fee or agree to an extension of the hiring period with the client (after which I may be employed by the client without further charge to the client).

I hereby agree to keep all information gained by Rotherwood and their clients strictly confidential.

I hereby give Rotherwood permission to obtain references on my employment as stated in references. I will inform Rotherwood immediately if any circumstances that may affect my work.

I hereby confirm that I am happy for Rotherwood to act as an Employment Business / Employment Agency on my behalf.

I Agree

Registration Form

Registration Form

Personal Details

Eligibility to work in the UK

Contact Details

Work Details

Criminal Convictions

Health and Disability

Work History

Employer 1

Employer 2

Employer 3

Self Evaluation

Payment Information

Additional Information

Data Protection Statement

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