Registration Form

At StaffPower Group, we value our candidate’s and client’s privacy and want you to know the choices and control you have over your information held by us. StaffPower Group are compliant and committed to the EU General Data Protection Regulations (GDPR) which is enforced by the Information Commissioner’s Office (ICO). In line with our internal policy regarding GDPR, we invite you to inform us if you are happy for StaffPower Group to retain your information and use that information in the future within our purposeful guidelines. You also have the right to request the Right to be Forgotten. Please request our full statement and policy regarding GDPR.

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Registration Form

"*" indicates required fields

Are you applying for a driving job?*

Yes

What is the Job Title of the position applied for:*

What is the Job Title of the position applied for:**

Personal Details: *

Title (Mr, Mrs, Ms, Other)*

First Name*

Surname

Home Telephone*

Mobile Telephone*

Email Address*

Date of Birth*

National Insurance Number*

First Line of Address*

Second Line of Address

City/ Town*

Postcode*

Your Licenses:*

UK Drivers License*

Currently Hold

Held but now out of date

Not Held

Fork Lift*

Currently Hold

Held but now out of date

Not Held

Counter Balance*

Currently Hold

Held but now out of date

Not Held

Reach*

Currently Hold

Held but now out of date

Not Held

CSCS*

Currently Hold

Held but now out of date

Not Held

Work Availability:*

Monday

Day Shift

Back Shift

Night Shift

Tuesday

Day Shift

Back Shift

Night Shift

Wednesday

Day Shift

Back Shift

Night Shift

Thursday

Day Shift

Back Shift

Night Shift

Friday

Day Shift

Back Shift

Night Shift

Saturday

Day Shift

Back Shift

Night Shift

Sunday

Day Shift

Back Shift

Night Shift

Are you looking for?*

Full Time Work

Part Time Work

Your Recent Employment History: *

Previous Employment Details*

Previous Employers Name*

Previous Employer Address*

Previous Employer Telephone*

Previous Job Title*

What was your reason for leaving?*

Last Date of Employment With This Employer*

2nd Previous Employment Details*

Previous Employers Name*

Previous Employer Address*

Previous Employer Telephone*

Previous Job Title*

What was your reason for leaving?*

Last Date of Employment With This Employer*

References*

First Reference*

First Reference Name*

First Reference Address*

First Reference Telephone*

What type of reference is to be provided?*

Verbal

Written

Second Reference*

Second Reference Name*

Second Reference Address*

Second Reference Telephone*

What type of reference is to be provided?*

Verbal

Written

Emergency Contact Details: *

First Emergency Contact*

Emergency Contact Name*

Emergency Contact Address*

Emergency Contact Telephone*

Emergency Contact Relationship To You*

Second Emergency Contact*

Emergency Contact Name*

Emergency Contact Address*

Emergency Contact Telephone*

Emergency Contact Relationship To You*

Areas of Expertise: *

Please tick all that apply to you:*

Training and Skills: *

Which of the following have you been trained in?*

Other Training Area

Which of the following have you had previous experience with?*

Other Experience Area

Working Time Traffic Regulations: *

Accordingly, please provide details of Working Time undertaken for any other road transport employers or employment business during the current 17 week reference programme:*

Have you accurately detailed all your working time during the current reference period and it is true and correct to the best of your knowledge*

I have

Are you currently engaged in any work, other than for Staffpower Group 1 which needs to be included in the calculations of your Working Time under the WTRT regulations? you will keep Staffpower Group 1 informed in writing as to the details of Working Time undertaken for other employers or employment businesses on a weekly basis; and you are responsible for your own working time & road transport directive hours, and you must maintain & keep within these regulations at all time*

Are you currently engaged in any work, other than for Staffpower Group 1 which needs to be included in the calculations of your Working Time under the WTRT regulations? you will keep Staffpower Group 1 informed in writing as to the details of Working Time undertaken for other employers or employment businesses on a weekly basis; and you are responsible for your own working time & road transport directive hours, and you must maintain & keep within these regulations at all time*

I am

I am not

With some of our employers you will be required to undertake training in health and safety and on site training to ensure you can safely carry out your role. Should you commence work with that employer following this training than on most occasions you will be paid for the time you invested. However, should you not start work with the employer following this training you will not be paid for this commitment. Please manually type your name below to confirm that you understand the above information and agree with these terms.

With some of our employers you will be required to undertake training in health and safety and on site training to ensure you can safely carry out your role. Should you commence work with that employer following this training than on most occasions you will be paid for the time you invested. However, should you not start work with the employer following this training you will not be paid for this commitment. Please manually type your name below to confirm that you understand the above information and agree with these terms.*

Drugs and Alcohol Policy

In compliance with the Road Traffic Act 1988 and the Transport and Works Act 1992. Drivers of road vehicles must not be under the influence of alcohol or drugs while driving, attempting to drive or when they are in charge of a vehicle. Staffpower Group 1 adopts a zero tolerance approach towards the misuse of alcohol and substances. The Company has responsibility to provide a safe and healthy working environment for all its employees, both temporary and permanent. The company recognises that this can be put at risk by those who misuse alcohol or drugs to such an extent that it affects their Health and Safety, the Health and Safety of others, their performance, their conduct or relationships at work. Anyone suspected or proven to be in breach of this policy will have their contract ended with immediate effect. Our clients may reserve the right to conduct testing procedures and we ask that our drivers comply.

Driver Name*

Signature*

Date*

Road Transport Directive Regulations

You must not drive any vehicle, operate any tail lift or use any gearbox that you do not have the relevant experience of, or the capability to operate safely without endangering others or yourself. You must adhere to UK road traffic legislation, UK tachograph legislation and the Road Transport Directive Regulations at all times. We ask that you return all tachographs within the required time period to comply with the current legislation and submit your licence to use every three months for re-checking, where a copy will be held on file. Should there be any changes to any driving licence you hold you should notify Staffpower Group 1 immediately. If you suffer any changes to your health which may affect your ability to safely operate a vehicle you should notify us immediately.

Signature*

Date*

DVLA Licence Check Consent

By providing the relevant information and signing this content form you are allowing Staffpower Group 1 to view your driving licence details using the government website www.gov.uk/view-driving-licence. This website allows us to view the following information: Vehicles you are legally able to drive Penalty points (under which category) Disqualifications Staffpower Group 1 will do these licence checks in accordance with clients requirements, usually every 3 months, this information will only be shared with any persons deemed relevant. In order to complete these check we require the following information:

Driving Licence Number*

National Insurance Number*

National Insurance Number

Signature

Signature*

Date*

Postcode*

Criminal Records Declaration

Have you ever been convicted of a criminal offence (which is not a spent conviction within the meaning of the Rehabilitation of Offenders Act 1974)?

Have you ever been convicted of a criminal offence (which is not a spent conviction within the meaning of the Rehabilitation of Offenders Act 1974)?*

Yes

If Yes, please provide details below*

Do you have any pending hearings which may result in a criminal conviction? *

Do you have any pending hearings which may result in a criminal conviction? **

Yes

If Yes, please provide details below*

Additional Driver Information

What is your preferred shift pattern?*

Monday to Friday

Saturday

Sunday

Nights Out

Days

Afternoons

Nights

Other

Other Shift Pattern

What is your preferred start time?*

If any, how many nights per week?*

If any, how many nights per week?

What is your mode of transport?*

Public

Car

Motorbike

Bicycle

Other

Other Mode of Transport

How far are you willing to travel?*

Up to 10 miles

10-20 miles

20-30 miles

Any

Tick any of the following that you own*

Tick any of the following that you own

Safety Boots

Hi-Vis

Sat-Nav

HGV Sat-Nav

How many drops are you comfortable with?*

1 to 5

6 to 10

11 to 15

20+

50+

Are you willing to help with the loading/unloading of deliveries?

Are you willing to help with the loading/unloading of deliveries?*

Yes

How much experience do you have driving Manual Vehicles?*

How much experience do you have driving Automatic Vehicles?*

When will you be available from?*

Do you have any pre-booked holidays?*

Are you registered with any other agencies?*

Yes

What companies have you worked for?*

Are there any companies you wouldn’t want to work for?*

Are there any companies you wouldn’t want to work for?

Any notes or requirements?*

Any notes or requirements?

Bank Details

You must provide us with current bank information to allow us to pay you for work you undertake with our agency, Staffpower Group 1. If you change your banking details it is your responsibility to inform us as soon as possible to allow us to pay you. Should you wish your pay to be sent to a third party bank account we will require the following from yourself and the third party; ID from the third party; (passport or birth certificate) written confirmation from your-self that you authorise the payment to be paid to the third party; authorisation from the third party they authorise your pay to be paid to them.

What is the name of your bank?*

What is your sort code?*

What is you account number?*

Data Protection

By completing this application form you are opting in to be contacted by Staffpower Group 1 in relation to any relevant work opportunities. You also acknowledge that your details will be kept on record for a minimum of 6 months in both paper and digital formats (unless you request to be forgotten). As a temporary worker for Staffpower Group 1 you acknowledge that your details (anonymised CV) will be passed on to prospective employers to support your job search and should you be successful in securing an interview, or job role your full name and medical information will be shared with the employer.

We will also obtain references from previous employers as part of quality and compliance. To allow you to receive payment for the work you undertake for us our payroll service provider, Impact, will receive your personal information and copies of your ID to allow you to be registered on the system.

Permission to Forward Personal Details - I hereby authorize and request that Staffpower Group 1 forward my personal details and/or CV to interested 3rd parties, specifical-ly prospective employers, previous employers for the purpose of reference and their payroll company for the purpose of payment. Your information will also be stored within our availability data list for the purpose of sourcing you appropriate work.*I give my full permission to this process as it may result in my future temporary or permanent employment (Please type your name in full to confirm this below)

Your Name*

PPE and Medical Information

Do you have any of these following:

Safety boots

High ‘vis’ clothing

Other

Other PPE

I understand that should I leave 2 weeks from my start date , the cost of my PPE work wear provided will be deducted from my wage*

Yes

Do you, or have you suffered with the following, please tick the appropriate boxes*

Do you, or have you suffered with the following, please tick the appropriate boxes

Other Medical

Working time regulations - According to The Working Time Regulations 1998, an employee cannot be required to work for more than 48 hours per week, unless they sign an individual opt-out agreement, agreeing that this limit will not apply to them. When signing, this is in agreement with the law. This does not change any of your statutory rights or terms and conditions.If you would like to work more than 48 hours a week as and when required, with no obligation, please tick the below options.

Working time regulations - According to The Working Time Regulations 1998, an employee cannot be required to work for more than 48 hours per week, unless they sign an individual opt-out agreement, agreeing that this limit will not apply to them. When signing, this is in agreement with the law. This does not change any of your statutory rights or terms and conditions.If you would like to work more than 48 hours a week as and when required, with no obligation, please tick the below options.

Yes I would like to work more than 48 hours a week where available

I declare that all the information I have provided is accurate and a true reflection of my personal details. I consent to my personal details being kept in digital and physical storage and for Staffpower Group 1 to seek work on your behalf (please enter full name)*

I declare that all the information I have provided is accurate and a true reflection of my personal details. I consent to my personal details being kept in digital and physical storage and for Staffpower Group 1 to seek work on your behalf (please enter full name)

Registration Form

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