• Personal
  • Tax & Pay Details
  • Previous Employment
  • Transport & License
  • Confirmations & Declarations
  • Finish

Personal Details

Full Name*


Address 1*
Address 2
Date of Birth*
Day *
Month *
Year *
Email Address*
Marital Status
Ethnic Origin
Landline number
Mobile number*
Next of Kin*
Next of Kin - Phone number*
Next of Kin - Email

Tax & Pay Details

Tax Details

NI Number*

Work Details and Skills

What kind of work are you seeking?
Worker Compliance

Booked Holiday

Account Information

Previous Company 1

Reason Left
Contact Position

Transport Details

Work Radius
Licence Number
Issue Date
Expiry date

Declarations and Confirmations

you are required to answer the questions marked by *

Basic Medical Questions

*Do you have any health issues or disabilities relevant which may make it difficult for you to carry out the role that you seek?
*Do you take regular medication?

If Yes, then you are required to answer questions 1, 2, and 3:  

Candidate Confirmations & Data Protection Statement

The information that you provide on this form & on any CV given will be used by Jobsworth Recruitment Solutions Ltd to provide you with a work finding service.
In providing this service to you, you consent to your personal data being included on a computerised database & consent to us transferring your personal details to our clients.
We may check the information collected, with third parties or with other information held by us.
We may also use or pass to certain third parties information to prevent or detect crime, to protect public funds, or in any other way permitted or required by law.
If, during the course of a temporary assignment, the client wishes to employ me directly, I acknowledge that Jobsworth Recruitment Solutions Ltd will be entitled to charge the client an introduction/ transfer fee, or arrange an extension of the hiring period with the client
(after which I may be employed by the client without further charges being applicable to the client).
I am aware that these terms and conditions have already been agreed between the Client and the Employment Business.


Working Time Directive Regulations

These regulations offer certain rights to all workers, temporary or permanent. The rights covered by these regulations are:
Workers can if they wish work a maximum of 48 hours per week
Workers must have a minimum of 1 hours rest period per day
Workers are entitled to 5.6 weeks paid holiday to include Statutory Bank Holidays

*If you wish to opt out of these regulations you may do so by indicating in the dropdown below. This does not affect your holiday entitlement or hourly pay rate. If you wish to opt back in then you can do so by providing 7 days written notice.

DBS Criminal Records.

As of 29 May 2013 you are no longer required to disclose information about any ‘filtered’ offences.
You are not required to disclose on any part of this form any convictions or cautions that have been ‘filtered’.
Guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website.
Subject to the filtering rules failure to declare a conviction that you must disclose may require us to exclude you from our register or terminate an assignment if the offence is not declared but later comes to light.

Age at the time of the offense Elapsed Time for a conviction Elapsed Time for a Caution
Under 18 5.5 Years 2 Years
Over 18 11 Years 6 Years

* I have criminal convictions, cautions, or pending prosecutions: (You must select from below)

Please Submit When Ready !