Application

Your Details

Title

Name*

First Middle Last

Gender*

Male

Female

D.O.B*

Age*

Select your Local Office*

Nationality & Eligibility to Work in the UK

What is your Nationality?*

Are you eligible to work in the UK?*

Yes

Identification - please tell us what ID you are going to provide*

UK Residents must provide either a UK Passport or UK Birth Certificate and a National Insurance Number. EU residents must provide a Share Code and a National Insurance Number. None EU or UK residents must provide a Visa or Residency document and a National Insurance number.

Please upload your ID, to include*

• passport or birth certificate • proof of National Insurance number (such as P45, tax office letter) • driving licence (especially if you are applying for a driving vacancy) • any relevant licences and certificates

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 100 MB.

Share Code*

EU Workers must provide a Share Code to be eligible to work in the UK.

National Insurance Number*

Address*

Street Address City County Postal Code

Telephone*

Other Telephone

Email*

Next of Kin

Name*

First name Last Name

Address*

Street Address City County / State / Region ZIP / Postal Code

Relationship*

Home Telephone*

Other Telephone

Bank Details

Please enter your bank and national insurance details, if you have any concerns, leave blank and once you start working, we will then need to contact you again for these details

Bank Account Number

Bank Sort Code

Name on Account

Bank Name

Do you have safety boots?

Yes

Do you have Hi Viz?

Yes

Do you have transport?

Yes

Do you have Digital Tacho (drivers)?

Yes

How far will you travel to work?

How did you hear about us?

Skills

Please list your skills below (such as order picking, FLT, 3.5T driver etc).

Skills

Criminal Convictions

Do you have any unspent criminal convictions that may restrict employment?*

If yes, please give details

Yes

Details

Medical Fitness

Doctors Name

Doctors Address

Street Address City County / State / Region ZIP / Postal Code

Doctors Telephone

Do you have any medical or health conditions that affect or restrict you in the work place that you wish to inform us about?*

If yes, please give details

Yes

Details

Are you currently taking any regular medication?*

If yes, please specify what this is for

Yes

Details

Employment History

Company Name

Company Address

Street Address City County / State / Region ZIP / Postal Code

Telephone

Position

Date of Employment

Duties

Reason for Leaving

Salary on leaving

If this work was through an agency, please give the name of the agency here.

Add second role

Yes

Company Name

Company Address

Street Address City County / State / Region ZIP / Postal Code

Telephone

Position

Date of Employment

Duties

Reason for Leaving

Salary on leaving

If this work was through an agency, please give the name of the agency here.

Add third role

Yes

Company Name

Company Address

Street Address City County / State / Region ZIP / Postal Code

Telephone

Position

Date of Employment

Duties

Reason for Leaving

Salary on leaving

If this work was through an agency, please give the name of the agency here.

Add forth role

Yes

Company Name

Company Address

Street Address City County / State / Region ZIP / Postal Code

Telephone

Position

Date of Employment

Duties

Reason for Leaving

Salary on leaving

If this work was through an agency, please give the name of the agency here.

Referees

NOTE: Only referees that have been detailed below will be contacted to supply a reference

Name

Company

Telephone

Address

Street Address City County / State / Region ZIP / Postal Code

Name

Company

Telephone

Address

Street Address City County / State / Region ZIP / Postal Code

Academic Education & Qualifications

University / College / School

Date Attended

Studies & Qualifications

University / College / School

Date Attended

Studies & Qualifications

University / College / School

Date Attended

Studies & Qualifications

Vocational Training & Qualifications

Company / Organisation

Date Attended

Studies & Qualifications

Company / Organisation

Date Attended

Studies & Qualifications

Company / Organisation

Date Attended

Studies & Qualifications

Other Relevant Experiences

Skills or Training etc

Manual Handling Test

Please complete the test below

What is manual handling?*

a) Pushing, pulling, bending, stretching, lifting

b) Only lifting

c) Using machines

d) Any lifting done by a man

What is the MAIN piece of legislation that applies to manual handling?*

a) The Electricity at Work Regs 1998

b) The Provision and Use of Work Equipment Regs 1998

c) The Manual Handling Operations Regs 1992

d) The Health and Safety at Work Act 1974

What should be considered when carrying out a manual handling assessment?*

a) Load, individual, task and environment

b) Load, age, environment, height

c) How many staff are employed

d) Nothing

Which of these injuries are associated with poor manual handling?*

a) Spinal/nerve injury

b) Muscle/ligament damage

c) Hernias

d) All of the above

It is safer to keep your knees straight when lifting?*

a) True

b) False

What can you do to reduce a heavy load?*

a) Drag it

b) Push it

c) Split it in two

d) Run quickly with it

What can you do if you feel uncomfortable about lifting something?*

a) Ask for help

b) Tell your manager

c) Do not lift it

d) All of the above

Can manual handling be avoided completely?*

a) Yes

b) No

Select those that must be considered when moving trolleys or cages*

a) Visual check before use – good repair?

b) Wheels run smoothly

c) Heavy items on the bottom, lighter items on top

d) Never overload the trolley/cage

e) Never obstruct your vision

f) Push the trolley/cage if visibility is good and if you can control stopping and steering

g) Move the trolley/cage at walking speed

h) If using a trolley/cage over uneven surfaces, or up/down a ramp or slope, ask for help

Is it a legal requirement for staff to receive manual handling training?*

a) Yes

b) No

Third Choice

What is the correct technique for lifting?*

a) Knees bent, back bent, feet together

b) It depends on what you are carrying

c) Always ask for help

d) Knees bent, back straight, feet apart

What should you do before carrying loads through narrow walkways?*

a) Ask someone to guide you through

b) Turn all of the lights off

c) Check the route is clear of obstacles

d) Have a drink

If you are applying for a driving job, please complete this section.

Licence number

Issue date

Expiry date

Conviction codes

Digital driver card expiry date (if applicable)

Should any driver incur any fixed penalty fine such as parking and / or a bus lane fine, this then must be settled by the driver, not A Star Recruitment Ltd or the company you are assigned to work at the time of the fine.

Work Time Directive - 48 Hour Maximum Working Week

This agreement is made between A Star Recruitment Ltd and the Worker.

AGREEMENT: The Working Time Regulations 1998 provide that the average working week, including overtime, shall not exceed 48 hours. By signing this agreement the Company and the Worker agree that the limit to working hours shall not apply to the Worker. This agreement will remain in force indefinitely or until such time as the Company or the Worker terminate the agreement. Written notification must be given to terminate this agreement.

Working Time Directive Confirmation*

I confirm agreement

I do not agree

Supply of Goods and Services

This agreement is made between A Star Recruitment Ltd and the Worker.

AGREEMENT: I hereby authorise A Star Recruitment Ltd to deduct any expenses arising from the supply of transport and work wear from any monies owing to me, where A Star Recruitment Ltd have provided such goods and/or services.

NOTE: A list of prices for goods and services will be provided as part of the registration process. Prices are subject to change.

Supply of Goods and Services Confirmation*

I confirm agreement

Final Declarations & Agreement

AGREEMENT: I hereby certify that the information I have provided in this document is true and to the best of my knowledge. I authorise A Star Recruitment Ltd to use any or all of this information in conjunction with my application for work placements. I confirm I have received and understood an A Star Welcome Pack.

Final Declaration Confirmation*

I confirm agreement

PLEASE NOTE: The information provided in this questionnaire is strictly confidential; however, we need your consent to allow us to disclose this information to clients of A Star Recruitment Ltd upon request. As a result of the information that you have provided you may be referred to your doctor for a medical fitness certificate before A Star Recruitment Ltd can offer you certain work placements.

Failure to disclose any information regarding your fitness, or make false declarations, may result in A Star Recruitment Ltd having to terminate your contract.

Untitled

First Choice

Second Choice

Third Choice

Untitled

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

Your Details

Nationality & Eligibility to Work in the UK

Next of Kin

Bank Details

Skills

Criminal Convictions

Medical Fitness

Employment History

Referees

Academic Education & Qualifications

Vocational Training & Qualifications

Manual Handling Test

If you are applying for a driving job, please complete this section.

Work Time Directive - 48 Hour Maximum Working Week

Supply of Goods and Services

Final Declarations & Agreement

Register With Us

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