Employee Registration Form
Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
County
Post Code
Gender
*
Male
Female
Right To Work in the UK
*
Yes
No
Please Upload Your Right To Work Document
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Any Unspent Convictions
*
Yes
No
Valid UK Drivers License
*
Yes
No
Any Points on Your Drivers License?
*
Yes
No
Please upload your British Passport or Your Residence Permit / BRP
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please Upload the Front of Your Drivers License
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please Upload the Back of Your Drivers License
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please Upload Proof of Address
*
Browse Files
Drag and drop files here
Choose a file
Examples of a proof of address include: Utility bill, tax bill, bank statement or other
Cancel
of
Have You Got Any Experience Driving a Van?
*
Yes
No
Relevant Work Experience Information
*
Disabilities
*
I have no disability
I have two or more impairments and/or disabling medical conditions.
I have a Specific Learning Difficulty (e.g. Dyslexia/Dyspraxia/AD(H)D
I have a social/communication impairment such as Asperger's syndrome/other autistic spectrum disorder
I have a long standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy
I have a physical impairment or mobility issues (e.g. difficulty using arms/using a wheelchair or crutches)
I am deaf or have a serious hearing impairment
I am blind or have a serious visual impairment uncorrected by glasses
Prefer not to answer
I have a disability, impairment or medical condition not listed here
Ethnicity
*
British Asian
Arab
Black British or Black African
White
Two or more races
Other
National Insurance Number
*
Submit
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