Candidate Registration Online Form

RM_Stats

Profile Picture^*

Title^*

Surname^*

Previous Name (If Applicable)

First Name^*

Middle Name

Date of Birth^*

Email^*

Username^*

Password^*

Enter password again^*

Address Line 1^*

City^*

Post Code

Country^*

Nationality^*

National Insurance Number^*

Home Phone Number

Mobile Number^*

What Position are you applying for?^*

Do you have a Work Permit?^*

Work Permit Expiry Date^*

Do you have a Residence Permit?^*

Residence Permit Expiry Date

Biometric Residence Permit No.^*

Passport Nationality^*

Place of Issue^*

Passport Number^*

Date of Issue^*

Passport Expiry date^*

Known restrictions in use

Next of Kin Details

Title^*

Surname^*

First Name^*

Address^*

Email Address

Relationship^*

Telephone

Mobile Number^*

Do you hold a current UK driving License?^*

Do you have your own car?^*

Please state which language you speak, including an indication of fluency^*

How did you first hear about this agency?^*

Would you like to add your qualifications?^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Would you like to add more qualifications?^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Would you like to add more qualifications?.^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Would you like to add more qualifications?..^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Would you like to add more qualifications?...^*

Institution Name^*

Qualification Achieved^*

Date Obtained^*

Please print details of all your employment history for a period of at least the last 5 years, in reverse date order, starting with your present or last position.

Current / Most Recent Employer:

Employer Address

Position Held:

Duties Performed

Date From

Date To

Reasons for Leaving

Would you like to add another previous employment details?^*

Employer Name^*

Employer Address Line 1^*

Country^*

Position Held:^*

Duties Performed^*

Date From^*

Date To^*

Reasons for Leaving^*

Would you like to add another previous employment details?.^*

Employer Name^*

Employer Address Line 1^*

Country^*

Position Held:^*

Duties Performed^*

Date From^*

Date To^*

Reasons for Leaving^*

Please give the names and addresses of 2 professional referees, whom we may approach for a reference.

Both referees must have known you in a professional capacity (Not relatives or friends) and one should be your present or most recent employer.

1st Referee:

Organisation Name^*

Job Title / Position within the company^*

Organisation Address^*

Contact Name^*

Telephone^*

Email^*

This is my^*

Length of time known^*

Second Referee:

Organisation Name^*

Job Title / Position within the company^*

Organisation Address^*

Contact Name^*

Telephone^*

Email^*

This is my^*

Select an Option

Length of time known^*

We pay agency staff by BACS (automatic transfer), Directly into their bank account. You will receive a full detailed pay advice, and by using BACS, your money will be available in your bank account sooner.

Bank/ Building Society Sort Code^*

Account Number^*

Account Holders Name^*

Bank/Building Society name^*

Bank/Building Society address^*

Building Society Account, please state its Reference Number for Automated (BACS) payment

Confidentiality Declaration^*

Registration implies acceptance of our codes of confidentiality. In the course of your duties you may have access to confidential information about your client. On No account must information relating to identifiable clients be divulged to anyone other than your branch manager or his/her assistant. You should Not disclose any information to your family, friends, neighbours etc... If you are worried by any information you have obtained and consider that you should talk about it to someone else make an appointment to speak in private to your superior/supervisor/manager. Failure to observe these rules will be regarded as serious misconduct which will result in the removal from the agency register.

I have read and I understand the above and I agree to abide by the contents therein.

Signature^*

Date^*

Under the rehabilitation of Offenders Act 1974 you are required to reveal ALL convictions. This has to include ALL spent convictions as defined under the act.

We actively promote equality of opportunity for all, as stated in our Equal Opportunities policy, which can be found in your handbook or at your local office. If you are in any doubt whatsoever about a declaration, you must discuss this with your local office manager.

A conviction does not automatically prevent you from registering, however failure to declare, will lead to immediate action. You are required to inform us if you are convicted of a criminal offence, cautioned or have a hearing pending in the future.

What is an enhanced disclosure?

An enhanced disclosure is for positions involving greater contact with Children or vulnerable adults. In addition to the information provided on a standard disclosure, the enhanced disclosure involves an additional check with the police, who check if any information is held on file that may be relevant. The police decide what (if any) additional information will be added to the disclosure.

In rare circumstances the police may write to the employer separately giving confidential information about an ongoing criminal investigation into the applicant. This information may NOT be released to the applicant.

Examples of information that may not be released:

- All spent convictions (from childhood up until present day)
- Investigations that have not led to a criminal conviction
- Any action taken against you by a local authority
- Driving offences received through a court of law
- Details of ongoing criminal investigations

If an offence is highlighted (when we receive your enhanced disclosure) that you have not declared your application may be withdrawn from the recruitment process.

For more information on CRB enhanced disclosures please call 0870 9090811 or visit their web site www.crb.gov.uk.

The information supplied on this form will be processed and stored in manual and computerised records for recruitment employment and management processes. You have the right to access this data. All information will be treated in the strictest confidence. Unsuccessful applicants will be retained for 3 months.

I declare that the information contained on this form is true and complete. I understand that if it is later discovered that any statement is false or misleading, it may be sufficient for cancelling any agreements made or I may be dismissed from employment by the company.

I consent to Right4Recruitment holding and processing this information and give permission for reference checking in connection with my application. I understand too that an Enhanced Criminal Record Bureau Disclosure will be sought.

Signature^*

Date^*

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Email

info@right4recruitment.co.uk

Phone

Office
01923 239 400
Outside office hours
07534 927 174

Business address

KK House/Blue Box, 1 Metropolitan Station Approach, Rickmansworth Road, Watford, WD18 7FR

Right4Recruitment

Our Services

Register with us

At Right4Recruitment we specialise in providing the best temporary and permanent staff to our clients in the health and social care sector.

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