Register with Personnel Leasing

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Company

This field is for validation purposes and should be left unchanged.

Personal Details

Name(Required)

First Last

Title(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City County / State / Region Postcode Country

Phone(Required)

National Insurance Number(Required)

Consultant(Required)

Please select which consultant you are dealing with at Personnel Leasing, so we can send them a copy of your application.

Right to Work in the UK(Required)

I am legally able to work in the UK

In line with UKBA guidance on the prevention of illegal working, we will need to verify and take a copy of your original ID documentation as evidence of your right to work in the UK if you are engaged by Personnel Leasing for temporary work.

Driving Status

Car owner?(Required)

License Status(Required)

Insurance Status(Required)

Endorsement Notes(Required)

License Other Notes(Required)

You have chosen 'other'. Please provide further information regarding your driving license

Education & Training

Please note that you will be required to provide evidence of any education and training that you declare here

Dates of Study (from)(Required)

Dates of Study (to)(Required)

Educational Establishment(Required)

Qualifications Gained(Required)

Registered Body(Required)

Registration No(Required)

Registration Date(Required)

Professional Conduct

Have you ever been the subject of a professional misconduct proceeding/disciplinary/suspension/ dismissal or are such pending or threatened against you?(Required)

Yes

Professional Conduct Details(Required)

Employment References

Please give details for the last 5 years. On of these must be your current or most recent employer. Students must state a previous employer and course tutor. You are free to name an additional referee if you wish. We will not contact any reference given without your consent.

Referees(Required)

I confirm the referees are aware you will contact them

Please tick this box to confirm that you have given consent for Personnel Leasing to contact the referees given below

Reference 1

Name(Required)

Position(Required)

Organisation(Required)

Date from(Required)

Date to(Required)

Role Type(Required)

Agency Name(Required)

Were you in past role 5 Years or longer?(Required)

Reference 2

2nd reference required so that we have references to cover 5 years + working experience

Name(Required)

Position(Required)

Organisation(Required)

Date from(Required)

Date to(Required)

Role Type(Required)

Agency Name(Required)

Additional Information for Reference 2

If relevant, use this area to provide further details to help us prove 5 years + experience

Personal Reference

Name(Required)

Position(Required)

Organisation(Required)

Relationship to you(Required)

Work Phone(Required)

Mobile Phone

Email(Required)

Job Preferences

Distance willing to travel(Required)

Current Salary / Hourly Rate(Required)

Desire Salary / Hourly Rate(Required)

Umbrella Company(Required)

Umbrella Company Contact(Required)

Would you like some help with IR35 rules?

I would like to discuss this with a Specialist

*The revised IR35 rules as applied to the public sector mean that it is unlikely you will be able to continue to use your company to process payments from us. We are able to introduce you to suitable alternatives should you not already have such in place.

Further Information & Declarations

How did you find out about us?

Which other agencies are you registered with?

Your Emergency Contact

Name of Contact(Required)

Relationship to you(Required)

Landline Phone

Mobile Phone(Required)

Candidate Declaration

I hereby confirm that the information given is true and correct. I consent to my personal data and CV being forwarded to Clients of Personnel Leasing. I consent to references being passed to potential employers, If, during the course of a temporary assignment, the Client wishes to employ me direct, I acknowledge that Personnel Leasing will be entitled either to charge the Client an introduction/transfer fee, or to agree an extension of the hiring period with the Client. Once such an extension is completed, I may be employed by the Client without further charge being applicable to the Client.

Your Name(Required)

Signature(Required)

Criminal Declaration

Due to the nature of the work for which you are applying, the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974 do not apply by virtue of the Rehabilitations of Offenders Act 1974 (Exceptions) (Amendments) Order 1986. Applicants are therefore NOT entitled to withhold information about convictions which for the purposes are ‘spent’ under the provisions of the Act, and in the event of employment, any failure to disclose such convictions may result in your removal from our register/assignment. The information given will remain confidential and only taken into account where, in the reasonable opinion of Personnel Leasing, the offence is relevant to the post for which you are applying. The information that you provide in this Declaration will be processed in accordance with the Data Protection Act 1998 (GDPR from may 25 2018) and will only be used for the purpose of determining your suitability for a particular vacancy.

Have you ever been convicted of a Criminal Offence or been subject to a Conditional Discharge or Probation Order in the UK or in any other country? If Yes, please give details below:

Yes

Criminal Offence Notes

Do you have any criminal proceedings pending? If Yes, Please give details below

Yes

Criminal Offence Notes

DBS Enhanced Disclosure?(Required)

DBS Update Service?(Required)

Data Protection Consent Form

Data Protection Consent(Required)

I herby confirm that my personal data may be held and disclosed by Personnel Leasing. It's clients and/or end hirers for the aforementioned purposes and in the manner set out below

I am aware that personal data relating to myself (including, where relevant, sensitive personal data*) whether obtained from myself or from any other source, will be retained by Personnel Leasing and any affiliate for the purpose of providing me with temporary work and/or employment opportunities and/or training.
I acknowledge that this may require my personal data to be forwarded to other persons and lawful organisations for the purpose of conducting checks and references, to find me work and for other lawful purposes related to Personnel Leasing’s recruitment services. Personnel Leasing will request references from my work, education and/or personal referees and in certain circumstances, with my consent, will obtain a credit reference from a credit reference agency and/or a Disclosure from the DBS. Personnel Leasing will not request a reference from my current employer without my consent.
I acknowledge that without my consent to process my personal data in this manner, Personnel Leasing is unable to assist me in my search for work.
I understand and agree that Personnel Leasing may pass information contained within and resulting from my application (including references, credit checks and Criminal Record Disclosures received and all forms completed by me) to other Personnel Leasing affiliates, the Client and/or the end hirer.
This information may be used by other Personnel Leasing affiliates, the Client and/or the end hirer for the purposes of processing my application, ongoing personal administration (where applicable, compli- ance and safeguarding audits undertaken by the Client and/or end hirer, and other lawful purposes relat- ed to my temporary assignment at, or employment with, the end hirer. I herby consent to Personnel Leasing passing such information to other Personnel Leasing affiliates, its clients and/or end hirers for the lawful purpose of seeking either temporary or permanent work, and when in assignment, complying with the requirements of the client and/or end hirer.
I herby confirm that my personal data may be held and disclosed by Personnel Leasing. its clients and/or end hirers for the aforementioned purposes and in the manner set out above.

Disclosure of Information & Confidentiality Agreement

Disclosure of Information

I have read and understood the requirements of this agreement and agree to abide by them. I understand that any breach of this undertaking may result in legal action being taken against me by the client that I am on assignment with.

Information that you may be party to, especially in relation to individuals, may be subject to the provision of the Data Protec- tion Act /GDPR or the legislation governed by these Acts. You must never disclose any information that could cause either you or the organisation you are on assignment with to be in breach of the law.
You must not use any information that you have access to for either personal gain or benefit, or pass this information to any- one outside of the organisation you are on assignment with.
You will be expected to abide by the client’s security procedures in relation to computers and the information held on these.

DBS Consent Form For Release of Information

Release of Information(Required)

I agree to Personnel Leasing releasing information contained within your DBS Disclosure to relevant third party organisations

• DBS update service
• I hereby consent to Personnel Leasing providing information contained within my disclosure that may be
necessary to assist with an assessment of my suitability for any vacancy.
• I will also provide Personnel Leasing with a copy of my DBS Disclosure certificate upon receipt, as I under- stand they are contractually obliged to provide a copy to relevant third party organisations.
• I will inform Personnel Leasing whenever anything changes in respect of the check, including if I am inter- viewed for, cautioned or convicted of any offence.

Release of Information Signature(Required)

Health Declaration

Consent

I declare that the information given herein is true and correct and is not presented in any way to mislead. I also declare that I will inform Personnel Leasing immediately if there are any relevant changes to this information. I am not aware of any condition, medical or otherwise, which would effect of limit my employment performance.

I agree that if I have given false or misleading information or omit to give relevant information now or in the future; this may result in termination of assignment without notice as well as a claim for recovery of any payments I have received together with a claim for loss of profits to Personnel Leasing.

Illness Impact(Required)

Do you have or have you ever had any illness/impairment or disability (physical or psychological) which may affect your work? E.g. diabetes, mental health issues, epilepsy etc

Yes

Medication(Required)

Do you take medication which may affect you at work?

Yes

Illness Impact(Required)

Do you have or have you ever had any illness/impairment or disability (physical or psychological) which may affect your work? E.g. diabetes, mental health issues, epilepsy etc

Yes

Past Illness(Required)

Have you ever had an illness/impairment /disability which may have been caused/made worse by work?

Yes

Pending Treatment(Required)

Are you waiting for/undergoing any medical treatment or Investigations?

Yes

Need for Assistance(Required)

Have you ever needed any adjustments/assistance to help you carry out your job? E.g. to the work environment, your hours or role?

Yes

Further Information on Health(Required)

Employer’s Liability Waiver

Liability Insurance Waiver

I can confirm that I do not employ any staff and that I am, therefore, exempt from obtaining Employer’s Liability Insurance

Disability - Equality Act 2010

The definition of disability under the Equality Act 2010 is anyone who has a physical or mental impairment which has a sub- stantial and long term adverse effect on their ability to carry out normal day to day activities. The information assists the Company in making sure reasonable adjustments as are necessary for anyone who has a disability and enables the Company to respond positively to this responsibility.

Disability - Equality Act(Required)

Disqualification for Caring for Children

I am registering for work that will give me access to children and young people under 18 or vulnerable adults, therefore I am required to provide Personnel Leasing with the following information

Disqualification Statement 1

I am not a parent of a child who at any time has been made the subject of a care order and no other order has been made with the purpose of removing a child from my care, other than a custody or residence order in favour of the other child's parent

Disqualification Statement 2(Required)

I have not been concerned with the management of, or had any financial interest in a voluntary or registered home which has been removed from the register

Disqualification Statement 3

I have not been refused registration of a voluntary or registered home in relation to any application made

Disqualification Statement 4

I have not been prohibited from being a foster parent or refused registration to be a child minder or provider of day care or had such registration cancelled

Disqualification Statement 5

I have not been convicted of an offence listed in the schedule to the regulations. (Please call for more details of offences if required)

Further Information(Required)