New Employee Details Form

New Employee Details Form

Thank you for accepting the position with Corrigenda, please complete the below forms, your information will be treated in the strictest confidence. All details are transmitted and stored encrypted on our systems.
Title
Name*

First NameLast Name
Preferred Name
Ethnicity Group*
Other (please specify)
Faith/Religion:*
Other (please specify)
Sexual Orientation:*
Other (please specify)
Gender:*
Date of Birth:*

DayMonthYear
Date
Nationality:*
National Insurance Number:*
Address:*

1st Line of Address

2nd Line of Address

CityCounty

Post Code
Mobile Number:*
Please enter a valid phone number.
Personal Email Address:*
example@example.com
Passport:*

If you do not have a passport you can upload your birth certificate
Cancelof
Driving Licence:*

Cancelof
Proof of Address:*

e.g. Bank statement or household bill dated within the last 3 months.
Cancelof

Emergency Contact Details
Emergency Contact Name:*

First NameLast Name
Relationship:*
Address:*

1st Line of Address

2nd Line of Address

CityCounty

Post Code
Mobile Number:*
Please enter a valid phone number.

Bank/Building Society Details
Name of Bank/Building Society:*
Branch:
Sort Code:*
Account Number:*
Name on Account:*

Medical Questionnaire

Please complete the Medical Questionnaire below, HR collects this information to adhere to the company’s Health and Safety policy, the details you provide will comply with the Data Protection Act and remains strictly confidential.
Are you currently taking or have been prescribed medication (excluding contraceptives)?*
Please Give Details:*
Are you currently receiving treatment for any physical or mental condition?*
Please Give Details:*
Do you suffer from any injury, illness, medical condition or allergy that might affect your ability to perform your duties? *
Please Give Details:*
Do you consider yourself to have a disability or registered disabled? *
Please Give Details:*
IsEngineer
Do you suffer from Allergies?*
Type of Allergy:*
Specific Allergens: (eg., peanuts, shellfish, penicillin, latex, etc.)*
Severity of Reaction:*
Symptoms of Reaction:*
Do You Carry Medication for This Allergy?*
If yes, please specify (e.g., EpiPen, antihistamines):*
Steps to Take During an Allergic Reaction:
Any known triggers to avoid in the workplace?
Any specific accommodations your require?

Job Role and Qualifications

Please ensure you upload all relevant qualifications for your job role.
Job Role:
Qualifications/Certifications (Current and in date):*
Qualification Certificates:

Cancelof
YesNo
Please provide your SKILLcard Registration number:*
SKILLcard Expiry Date:*

DayMonthYear

Driver Questionnaire:
How many years have you held your Full UK Licence for?*
Have you had any motoring accidents or made any insurance claims in the last 4 years? *
Please Give Details:*
Have you been issued with a fixed penalty ticket (other than parking) or been convicted of, or received a police caution for any motoring offence or other criminal offence?*
Please Give Details:*
Have you got a prosecution pending or any fixed penalty ticket in dispute?*
Please Give Details:*
Have you ever been refused insurance or had any special conditions imposed? *
Please Give Details:*
Do you have any disability which could affect the ability to drive?*
Please Give Details:*
Has the disability been declared to the DVLA?*

DVLA Check Code
DVLA Check Code:*
Driver Licence Number:*

Uniform Order

Please put the size required (Size information below table):

Rows	Size
Polo Shirt - Black (S/M/L/XL/XXL/XXXL)
T-Shirt - Black (S/M/L/XL/XXL/XXXL)
Sweatshirt - Black (S/M/L/XL/XXL/XXXL)
Fleece - Black (S/M/L/XL/XXL/XXXL)
Waterproof Jacket (S/M/L/XL/XXL/XXXL)
Work Trousers (Waist/Length)
Safety Boots

* Please note: If you prefer to purchase your own work trousers & Safety Boots the Company will contribute the following to the cost:
- Work Trousers: £30.00
- Safety Boots: £45.00
* This will need to be claimed back via by Corrigenda expense’s process once you have started.
YesNo
YesNo
Please note: If your employment terminates within 12 months, you will be liable to repay up to £150 in costs as per terms and conditions of your contract of employment.

References

Please provide contact details of your last two employers for references.
Company:*
Name*

First NameLast Name
Reporting Relationship:*
Phone Number:*
Please enter a valid phone number.
Email:*
example@example.com
Company:*
Name*

First NameLast Name
Reporting Relationship:*
Phone Number:*
Please enter a valid phone number.
Email:*
example@example.com

Working Time Directive
Agreement to opt out of maximum weekly working time

Under regulation 4(1) of the Working Time Regulations 1998 a worker's average working time, including overtime, must not exceed 48 hours a week unless the worker has previously agreed otherwise in writing.

Please sign below to confirm your agreement that this limit on your working hours will not apply, and that your average working time may therefore exceed 48 hours a week.

You may terminate this agreement by giving three months' written notice at any time. Unless it is terminated in this way, this agreement shall remain in force until your employment with us ends.
I agree that the statutory maximum average working time of 48 hours a week shall not apply to my employment with Corrigenda Ltd and that my average working time may therefore exceed 48 hours a week.

Clear
If you do not agree to this then please just click Next

Additional Information
Data Protection Notice

The Company requires certain information before you start employment, to ensure you will be able to perform the requirements of the job and give reliable service, and to ensure compliance with relevant Health and Safety regulations. The information is also required in order to establish whether any reasonable adjustments may need to be made to assist you in performing your duties, in accordance with the Equality Act 2010.

The information you provide will be treated in the strictest confidence and used only for the purposes detailed above in compliance with the Data Protection Act 2018.
Consent

Do you consent to us making images (including video images) of you and using them to publicise the business and services of Corrigenda Limited. Do you agree that we may store those images digitally for that purpose with the same degree of security that we use for client data.

You may at any time require us to stop using such images and we will be prohibited thereafter from using them in any new application. It will not prevent us continuing to use them in an existing application. If at any time we are not using the images you may request us to delete them. We will supply you with copies of the images upon your request.
I agreeI do not agree
Any Additional Information you feel is important for us to know:
YesNo
What dates of holiday do you have prebooked?*
Any Additional Documents:

Cancelof
Please verify that you are human*
By clicking submit you are confirming that the information given in this Questionnaire is complete and accurate to the best of your knowledge.
Sender Name
Sender Email
example@example.com
Should be Empty:

New Employee Details Form

Emergency Contact Details

Bank/Building Society Details

Medical Questionnaire

Job Role and Qualifications

Driver Questionnaire:

DVLA Check Code

Uniform Order

References

Working Time Directive

Additional Information