Employment agency candidate registration form template

Equal Opportunities

[Agency Name] is committed to a policy of equal opportunities for all work seekers and shall adhere to a policy at all times and will review on an on-going basis on all aspects of recruitment to avoid unlawful or undesirable discrimination. We will treat everyone equally, irrespective of gender, sexual orientation, gender reassignment, marital or civil partnership status, age, disability, colour, race, nationality, ethnic or national origin, religion or belief, political beliefs or membership or non-membership to a trade union and we place an obligation upon all staff to respect and act in accordance with the policy.

[Agency Name]shall not discriminate unlawfully when deciding which candidate/temporary worker is submitted for a vacancy or assignment, or in terms of employment or terms of engagement for temporary workers. [Agency Name] will ensure that each candidate is assessed only in accordance with the candidate’s merits, qualification and ability to perform the relevant duties required by the particular vacancy.

Personal Information:

Full Name: ________________________________________

Address: __________________________________________

City: ___________________ Postal Code: ____________

Email Address: _____________________________________

Phone Number: _____________________________________

Date of Birth: //____

Gender: [ ] Male [ ] Female [ ] Other

Nationality: ______________________________________

Are you free to take up employment in the UK with no current immigration restrictions?

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 of your right to work in the UK.

[ ] Yes [ ] No

If no, please provide details:

Employment History:

Current Employment Status: [ ] Employed [ ] Unemployed [ ] Self-employed [ ] Student

Current Employer (if applicable): ____________________

Job Title: _________________________________________

Brief Description of Current/Previous Job: ____________

Previous Employment History: _______________________

Education Qualifications: ___________________________

Skills and Experience:

Industry Experience: _______________________________

Key Skills: ________________________________________

Certifications or Licenses: __________________________

Language Proficiency: ______________________________

Job Preferences:

Desired Job Title/Role: ____________________________

Preferred Industry/Field: ___________________________

Type of Employment: [ ] Full-time [ ] Part-time [ ] Temporary [ ] Contract [ ] Permanent

Desired Salary/Rate: _______________________________

Availability:

Notice Period: ____________________________

Availability to Start: //____

Preferred Work Schedule: ___________________________

Additional Information:

Criminal convictions: 

Do you have any unspent* Criminal Convictions? [ ] Yes [ ] No

If yes, state convictions & dates:

*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 and 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 were, in the reasonable opinion of Bridge Recruitment UK Limited, 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.

Health & 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 our your needs in order to perform the job or position sought.

Do you have any health issues or a relevant disability which may make it difficult for you to carry out functions which are essential for the role you seek? [ ] Yes [ ] No

If yes, please specify:

If you have a disability, what are your needs in terms of reasonable adjustments in order to access this recruitment service and to attend interview, or to take aptitude tests etc.?  Please specify:

Credit check:

Clients may, in certain circumstances, request a credit check be obtained in addition to your work references. In such cases, you will be made aware that such a check is required. Should such a check be undertaken, please indicate your acceptance using an “X” below:

[ ] Yes [ ] No

I give my consent that where appropriate and as a requirement of the role, a credit check may be undertaken and the resulting information disclosed to appropriate parties. I understand that such information will be held on file but will be subject to relevant legislation regarding privacy and disclosure.

Reference details:

Current or most recent Employer

Name:

Job title:

Company:

Address:

Tel No:

Email:

Consent to contact: [ ] Yes [ ] No

Second Referee

Name:

Job title:

Company:

Address:

Tel No:

Email:

Consent to contact: [ ] Yes [ ] No

Data protection statement:

[Agency Name] provides work-finding services to its clients and candidates. We must process personal data (including sensitive personal data) so that we are able to provide these services – in doing so, we act as a data-controller. This why we have asked 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. Please see our relevant Privacy Statement attached.

Current regulations stipulate that an applicants’ permission must be sought prior to their details being submitted for a vacancy. As a professional Agency, we always endeavour to do this in order that you have full details regarding any opportunity for which we are considering you. There may, however, be rare occasions when a client will introduce a deadline for receipt of application and we are unable to establish contact with you during this time period. In such an instance, would you like us to submit your details for vacancies we feel are appropriate without your prior consent? Please select your preferences from the tick boxes below. This does not commit you to progressing applications you later feel unsuitable once a full verbal brief is provided.

In exceptional circumstances, I give permission for my CV/details to be submitted to client(s) without my prior consent for vacancies that meet my requirements as outlined during my initial contact with [Agency Name]. I understand that, should this occur, [Agency Name] will brief me at their earliest opportunity.

[ ] Yes [ ] No

Please do not submit my details to the following organisations without seeking my consent in advance:

Working time directive opt-out agreement:

I hereby agree that I may work for more than an average 48 hours per week. If I change my mind, I will give [Agency Name] three months’ notice in writing to end this agreement.

Declaration:

I certify that the information provided in this form is true and accurate to the best of my knowledge. I understand that any false information may result in the termination of my registration with the agency.

Signature: ________________________ Date: //____