New sick leave
PersonPlus
Company name
*
Filled in by
*
E-mail address
*
Employee information
First name
*
Last name
*
Name according to payslip
*
Dat of birth
*
-
Dag
-
Maand
Jaar
2 digit day, 2 digit month, 4 digit year
Datum
Phone number
*
E-mail address
*
Business function
*
Allround waitress
Barkeeper
Chief waitress
Head waitress
Waitress
Dishwasher
Housekeeping
Allround employee fastservice
Chief cook
Kitchen assistant
Cook
Employee fastservice
Sous chef
Foreman dishwashing area
Self-employed cook
Assistant manager
Manager
F&B manager
Floor staff
Kitchen staff
HR Manager
Other
If you've filled in 'Other', please write down your function in the Remarks
Address
*
Postal code
*
City
*
Contract information
Type of contract
*
Fixed-term
Permanent (open-term)
Type of employment
*
Regular
Unknown
On-call employee with 0-hour contract
On-call employee with min-max contract
On-call employee with prior agreement
Temporary employee
BBL Student
Intern/Trainee
Director-major shareholder
Contract start date
*
-
Dag
-
Maand
Jaar
2 digit day, 2 digit month, 4 digit year
Datum
Contract end date
-
Dag
-
Maand
Jaar
2 digit day, 2 digit month, 4 digit year
Datum
Contract hours
*
Sick leave
Is there a safety net/no-risk policy?
*
Yes
No
Has there been an industrial accident?
*
Yes
No
First day of the illness
*
-
Dag
-
Maand
Jaar
2 digit day, 2 digit month, 4 digit year
Datum
Expected duration
*
< 6 weeks
> 6 weeks
Remarks
Privacy Statement
*
I agree
Versturen
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