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Please Complete Our Registration Form

Personal Details
*Title:  Mr Mrs Ms Miss

 

*First Name:

*Surname:

*Address:
*Status:

*DOB (ddmmyy)

*Age:

*Nationality:

NI Number:

Passort Number:

*Email:

*Contact Number:

Home:

Mobile:

Car Driver:

Do you own your own car?

Driving Licence Number:

 

Next of Kin

Name:

Relationship:

Address:

Contact Number:

  

 

General Health
Have you ever had a serious illness or accident?
Do you suffer from allergies that we should be made aware of eg. Asthma etc?
Are you registered disabled?
Are you in good general health?

 

Education
School /College
Dates Attended
Qualifications

 

 

Employment History

Start from the most recent or present position.
Employer Name & Address
Job Description
Salary (inc bonus or commision)
Are you currently employed?

Additional information:

 

References

Please give details of 2 references that we may contact, 1 reference should be your previous employer.
Name
Address
Connection

 

 

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. I consent to references being passed onto potential employers.

If during the course of a temporary assignment, the client wishes to employ me direct, I acknowledge that NB Personnel will be entitled either to charge the client an introduction / transfer fee, or 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).

*

*Security Code:

Please make sure you complete all fields where indicated *