0333 900 2535
info@ucirecruit.com
Registration Form
Personal Information:
Birth Date
Emergency Contact Information:
Referees:

COMPETENCY

Do not carry out tasks involving the use of power tools or operate plant machinery unless you have received formal training and are have a certificate to prove your training. Please indicate below any Tools you are competent to use properly and safely and also any Training & Qualifications held (e.g. Tickets Held, Training Undertaken, NVQs & Safety Cards):

MEDICAL NOTES

Do you suffer from any health problems or have been seen by your GP in the last 12 months concerning health problems, which may affect your ability to carry out your duties? (Incl. lifting, manual handling, epilepsy, diabetes etc.)

Have you ever left, been retired from or denied a job on health grounds?

Have you ever been involved in an industrial accident and/ or made any insurance claims on a previous employer for loss or compensation?

If you answered yes to any of the above, please give full details here (e.g. illness, dates, medical attendance etc.)

Attachments

Files must be an image (jpeg/jpg/png) and no more than 3mb

Passport

Utility bill / CV

CSCS Card

Tick to confirm you have read the terms & conditions and health & safety policy