Work4People ~ CANDIDATE APPLICATION FORM

  •  PERSONAL DETAILS                                                                                     

  • Date of birth*
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  •  NATIONAL INSURANCE                                                                         

  • Do you have a National Insurance Number?*
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  •  TAX DECLARATION                                                                                       

  • Please tick the box below that is most relevant to you*

  •  CRIMINAL CONVICTIONS                                                                           

  • Do you have any unspent criminal convictions?*

  •  BANK DETAILS                                                                                            

    Please provide the details of the bank account that you would like your wages to be paid into. By completing your details below you agree that you are happy for Work4People Ltd to pass this information to an external payroll company for payroll processing purposes. Should you change your bank details at any point during your assignment with Work4People Ltd, please contact us immediately.

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  •  HEALTH ASSESSMENT                                                                                

  • Do you have any condition or disability that requires reasonable adjustments to bemade to the workplace?*
  • At present, or in the last seven days, are you suffering from diarrhoea and/or vomiting?*
  • At present, or in the last seven days, are you suffering from Stomach pain, nausea or fever?*
  • At present, are you suffering from: skin infections of the hands, arms or face. E.g. boils, styes, septic fingers, discharge from eye / ear / gums / mouth?*
  • At present, are you suffering from jaundice?*
  • Do you suffer from a recurring bowel disorder?*
  • Do you suffer from recurring infections of the skin, ear or throat?*
  • Have you ever had typhoid or paratyphoid fever or are you now known to be a carrier of Salmonella Typhi or Paratyphi?*
  • Are you a carrier of any type of Salmonella?*
  • In the last 21 days have you had contact with anyone, at home or abroad, who may have been suffering from typhoid or paratyphoid?*
  • Have you been abroad in the last 6 weeks? If so, please list all of the countries you visited.*

  •  48-HOUR OPT OUT                                                                                   

    If you’re over 18, you are able to choose to work over an average of 48 hours per week and this process is known as “opting out”.

    This is your choice and is entirely voluntary. Whatever your decision it will not have an impact on the service you have from us and how we treat you. If you want to change your mind you can do so by writing to us and giving us three months’ notice.

    Once you have made your decision, please sign and date below. Only sign and date in one of the boxes.

    • I wish to opt-out of the 48-hour working week restriction under the Working Time Regulations 1998.
    • I do not wish to opt-out of the 48-hour working week restriction under the Working Time Regulations 1998.

  •  NEXT OF KIN                                                                                               

    In the event of an emergency, please could you provide us with the details of at least one person that you would like us to contact.

  •  DATA PROTECTION DECLARATION                                                    

    In order to help you find work, we need your permission to process some of the information that you have given us. Please read the statement below and then sign and date if you agree to us processing your data. Should you wish to withdraw your consent at any point then you can do so by contacting the offices of Work4People Ltd.

    I agree to my data being held and processed by Work4People Ltd, both electronically and manually, during the course of my assignment for the purpose of the administration and management of their staff and their business and for compliance with applicable laws, procedures and regulations.

  •  CANDIDATE'S DECLARATION                                                              

    I confirm that all of the information I have provided in this document is true and accurate at the time of completion. Should any of my details change, I will notify Work4People Ltd immediately.

  •  NIGHT WORKER'S HEALTH ASSESSMENT QUESTIONNAIRE         

  • Have you had any medical problem in the past that has prevented you from working at night?*
  • Are you diabetic?*
  • Are you subject to angina, or other heart problems that may affect your fitness?*
  • Have you had duodenal or stomach ulcers in the past, or are you under treatment for those at present?*
  • Have you had any continuing bowel problem, for instance following major surgery?*
  • Do you have any chronic chest problem such as asthma, emphysema or bronchiectasis?*
  • Do you have any disability affecting mobility that will cause difficulties in arranging night work?*
  • Do you have any recurrent or continuing sleep disturbance requiring medical advice?*
  • Are you having specialist care requiring your attendance at hospital clinics for treatment?*
  • Do you have any other health problem that affects your fitness for night work?*
  • Are you taking any medication to a strict timetable?*

  • I confirm that all of the information I have provided above is true and accurate at the time of completion. Should anything change, I will notify Work4People Ltd immediately.

  • ENGLISH TEST

  • Please tick the correct answer below:

  • 1. What shape is this?*
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  • 2. What colour is the shape?*
  • 3. If the fire alarm sounds whilst at work, what should you do?*
  • 4. What does this sign mean?*
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  • 5. If you have an accident at work, what should you do?*
  • 6. What items are these? *
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  • *
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  • Select the correct sentence:

  • 7. Do you like coffee?*
  • 8. Can I park here?*

  • 9. Please check the first letters and numbers in the box and the circle the identical set of letters and numbers:

  • ABCD1234*
  • DGHZ3567*
  • JBDB1986*
  • ZQRK9807*
  • 10. Which two numbers add (+) up to make 30?*
  • Date*
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