Registration Profile Form

1. Position Applied For:

Please state the position that you are applying for:

2. Personal Details:

Surname (family name):	Home Telephone Number:
First or Given Name(s)	Mobile Number:
Address:	Email Address (if applicable):
Postcode:	National Insurance Number:

Are you a member of a Trade Union? If YES, which one?
Do you have immigration permission to work in the UK?	Yes No
Have you ever been convicted of a criminal offence?	Yes No
Nationality:

3.Skills: (i.e. Pipe laying, Kerb laying etc...)

4. CSCS/CPCS Certificates and/or Training:

Please tick appropriate boxes if you have any of the following:

Full UK driving licence		Cherry Picker		Slinger / Signaller
HGV		Dumper		Crane
Hiab		Roller		PTS
NVQ		Telescopic Forklift		First Aider
		360

Other -please give details:
CSCS/CPCS Registration Number:

5. Employment History:

Present Employer:	Previous Employer:
Address:	Address:
Date Employed From:	Date Employed From:
Date Employed To:	Date Employed To:

 

6. Health:

Are you in good health?

Yes No

Do you have any physical or mental illness which would be considered a disability under the Act?

Yes No

If you have answered yes, please give details including any adjustments that would be necessary within the workplace if your application is successful:

Data Protection: The information you provide on this form will be used by Site Logistics to provide you work finding services. In providing this service to you, you consent to your personal data being included on a computerised database and consent to us transferring your personal details to our clients.

I declare that the information I have given is to the best of my knowledge and belief, true and complete - and I consent to my personal information being forwarded to clients: