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(if you have lived in current address for less than 5 year add addition address details for last 5 years.)

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Area of experience(s)

Operations

Equipment

Warehouse

Trainings

Job Titles

Area Of Experience(s)

Relevent experience and other supporting information/candidates personal statement

Do you have or have you ever suffered from

Do you suffer from any disabilities affecting your

Yes in any details a box, Please give details

PERSONAL HEALTH DECLARATION

I declare that all the above statements are true and complete to the best of knowledge. I know of no medical reason why I should not work in a health and social care environment. Should the situation change whilst either:

  • I am engaged on a temporary assignment by Highview Personnel Ltd
  • In between assignments for Highview Personnel Ltd

I will immediately notify the relevantHighveiw Personnel Ltd Office and, if appropriate, the Company where I am working.

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HEALTH AND SAFETY POLICY AND DECLARATION FOR TEMPORARY WORKERS

It is important for Highveiw Personnel Ltd to take all reasonable steps to ensure your health, safety and welfare whilst on assignments (as far as practical). However, note that it is the ultimate responsibility of the Client to provide you with a work environment that complies with current health and safety regulations.

It is your responsibility to look after your own health, safety and welfare, and that of others by:

  • Familiarising yourself with The Client s Health and Safety Policy, Fire and Evacuation arrangements and First Aid arrangements. Ensuring that you co-operate with the Client s Fire and First Aid arrangements.
  • Complying with any induction and task training, supervision and requirements of any relevant risk assessments.
  • Ensuring that any Personal Protective Equipment provided by the Client is used in accordance with the instructions given.
  • Only carrying out tasks that you are trained for and competent to carry out, and have been authorised to undertake within the agreed premises or area.
  • Notifying Highview Personnel Ltd of any changes in your circumstances that could affect your ability to work or put you at risk within the work place.
  • Taking care of company property entrusted to you, refraining from horseplay and abuse of welfare facilities.

YOU SHOULD ALSO:

  • Report to your supervisor any defects in the office or its equipment and ensure that both are in a safe and secure state when unattended.
  • Report all incidents that could result in personal injury or property damage to the Client and you.
  • Report any personal work related injury or disease to the Client and you.
  • Set a personal example in the workplace.
  • I declares that I have read & understood details of the health & safety policy and accept to adhere to it .

I declares that I have read & understood details of the health & safety policy and accept to adhere to it

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BANK DETAILS (give business account details if operating under own company)
IMPORTANT NOTE

This section must be completed in full. Your application cannot be considered if FULL and APPROPRIATE reference information is not supplied. Any job offer made to you will be dependent on satisfactory references received. This is a mandatory requirement.

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Because of the nature of the work for which you are applying, this post is exempt from the provisions of Section 4 (2) of the Rehabilitation of Offenders Act 1974, by virtue of the Rehabilitation of Offenders Act 1974 ‘Exemptions’ Order 1975.

Applicants are therefore not entitled to withhold information about convictions or police cautions which for other purposes are ‘spent’ under the provisions of the Act and in the event of employment.

  • Any failure to disclose such convictions could result in dismissal or disciplinary action.
  • Any information given will be completely confidential (according to the Data Protection Act 1998) and will only be considered in rel ation to an application for positions to which the Order applies.

Have you ever been convicted of a:

Have you ever received a:

I declare that:

  • All information given in this form is true to the best of my knowledge.
  • All documents and certificates supplied to support this application are genuine and I have no restrictions of working in UK.
  • I have read and understood the terms and conditions and agree to comply with the current Health and Safety at work Act.
  • I understand that pay is inclusive of my holiday pay entitlement
  • I understand that the data I have provided in this application is protected by the Data protection Act 1998 and will be secure under Highview Personnel Ltd custody. The Company can use deal with the data directly or indirectly in relation to the role I have applied for in this form
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N/B According to Working Time Regulation, on average an adult worker should not work for more than 48 hours in a week. However you can opt out by signing below.

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I confirm that during every assignment and afterwards where:

  • To hold information relating to the client in the strictest confidence, ensure it is kept safely and securely when not in use. I acknowledge that no information is to be removed from the client’s premises without the permission of the client
  • To use such information only for the purpose of the work for which it was given.
  • I have read and understood the terms and conditions and agree to comply with the current Health and Safety at work Act.
  • Not to disclose to any third party or copy the information except as is required in the course of my duties.
  • Any breach, either by me or third party, may result in legal proceedings being bought by the client against me to recover any losses that have occurred as a result of breach.
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