Next of Kin Information

Job applied for

Last Three Employers

Reference Information

Have you worked for an agency before?

Ethnic Category

The following categories are based on those used in the 2001 census as recommended by the EHRC. Please note the ethnic questions are not about nationality, place of birth or citizenship. UK citizens can belong to any of the ethnic categories indicated.

Please tick the box below which best describes the ethnic category to which you belong.

White

Mixed

Asian or Asian British

Black or Black British

Chinese, Chinese British or other ethnic group

Disability

Please state if you have any long-term physical or mental condition that affects your ability to carry out day-to-day activities. (Advice can be obtained from the EHRC 0845 604 6610).

Date of birth

Please state your date of birth.

Criminal Convictions

Do you have any unspent* criminal convictions?

*Certain types of employment and professions are exempt from the Rehabilitation of Offenders Act 1974 and in those cases particularly where the employment is sought in relation to positions involving working with children or vulnerable adults, details for all criminal convictions must be given. The information given will be treated in the strictest of confidence and only taken into account where, in the reasonable opinion of Robertson Recruitment Services Ltd, 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 or terminate an assignment if the offence is not declared but later comes to light.

Permission to work in the UK

Do you have full right to work in the UK?

In line with Home Office 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 to be engaged by Robertson Recruitment Services Ltd for temporary work.

Health and Disability

The following questions on health and disability are asked in order to find out your needs in terms of reasonable adjustments to access our recruitment service and to find out your needs in order to perform the job or position sought.

Do you have any health issues or a disability relevant to the position or role you seek?

How to Lift Heavy Objects Safely

• Make sure you are standing directly in front of the item you wish to lift.
• Check if the item has handles which you could use.
• Know where you are taking the object before you begin.
• Position your feet evenly (shoulder width apart).
• Keep your back straight and stand up tall.
• Tighten your stomach muscles.
• Squat to the floor by bending your knees- DO NOT move your upper body.
• Take hold of the object firmly with both hands.
• Distribute the weight evenly - make sure you are not unbalanced.
• Keeping the object close to your body, begin to stand up by straightening your legs (This will use your leg muscles and shouldn’t put strain on other areas).
• Stand up slowly. Do not move quickly or jerk when doing this.
• You can now walk with the object (but be careful not to twist your body unnecessarily). Take small steps if possible.
• If you are carrying a large object which restricts your view, ask if someone can guide you. This will prevent you from tripping or bumping into objects.
• When placing the item down, bend your legs.
• Remember to keep your back straight as you bend down again.
• Be careful to lower each side of the object to the floor separately- this will avoid trapping your fingers under the weight.

Please can you answer the following questions by checking the right answer.

What do you think is the most likely part of your body to be injured whilst moving a heavy load?

Which of the following is advisable when lifting a load?

Before moving a load what should you do in the first instance?

If a load has to be moved a long distance what should you do?

What is the maximum load that an individual may lift?

Data Protection Statement

Robertson Recruitment Services Ltd provide 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 ask 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. Click the link for Robertson Recruitment Services Ltd privacy policy

Candidate Declaration

I hereby confirm that the information given is true and correct. I agree to my personal data and cv being forwarded to clients, intermediaries, recruitment partners, payroll providers and IT providers. I consent to references being passed onto potential employers.

I consent to and authorise Robertson Recruitment Services Ltd to gain reference information from my previous employers to assist me in gaining future employment

If, during the course of a temporary assignment, the Client wishes to employ me direct, I acknowledge that Robertson Recruitment Services Ltd will be entitled either to charge the client an introduction/transfer fee, or to agree an extension of the hiring period with the Client (after which I may be employed by the Client without further charge being applicable to the Client).