Register With Staff Central

Personal Details

First Name

Last Name

Address Line 1

Address Line 2

City/Town

Postcode

Mobile Number

National Insurance Number

Date Of Birth

Next Of Kin/Emergency Contact Name

Emergency Contact Number

Relationship To You

Do You Have The Right To Work In The UK?

Yes

Nationality

If You Have A Share Code Please Enter Here

Employment Details

Do You Have A CV To Upload?

Yes

Please Upload Your CV

Choose File

Employment History

Name Of Last Employer

Date From

Date To

Job Title

Hourly Rate

Referees

Referee Name

Job Title

Company

Telephone Number

Previous Agencies

Agency Name

Company Name

Job Title

Dates

Hourly Rate

Please Indicate Which Sectors You Would Be Happy To Work In

Additional Information

Are You Currently In Employment?

Yes

What Is Your Notice Period?

Are You Available For Work Immediatly?

Yes

When Would You Be Available?

Do You Have Your Own Car To Get To Work?

Yes

Can You Work Any Shifts?

Yes

Which Shifts Can You Work?

Do You Have Any Of The Following?

Do You Have Any Known Health Issues That Your Employer Should Know About?

Yes

Do You Have Any Criminal Convictions?

Yes

Would You Be Happy To Participate In A Drug Or Alcohol Test If Required?

Yes

Employee Statement

These questions will help you to choose the statement that matches your circumstances. The statement you choose helps your employer to apply the correct tax code.

Do You Have Another Job?

Yes

Do You Receive Payments From A State, Workplace Or Private Pension?

Yes

Since 6th April Have You Received Payments From Any Of The Following?

Student Loans

Do You Have A Student Or Postgraduate Loan?

Yes

Do Any Of The Following Statements Apply?

To avoid repaying more than you need to, tick thecorrect student loan or loans that you have – use the guidance below to help you.
Please tick all that apply.

Plan 1 - You have Plan 1 if any of the following apply:
• you lived in Northern Ireland when you started
your course
• you lived in England or Wales and started your course
before 1 September 2012

Plan 2 - You have Plan 2 if:
You lived in England or Wales and started your course
on or after 1 September 2012.

Plan 4 - You have Plan 4 if:
You lived in Scotland and applied through the
Students Award Agency Scotland (SAAS) when you started
your course

Postgraduate Loan - You have a postgraduate loan if any of the
following apply:
• you lived in England and started your postgraduate
master’s course on or after 1 August 2016
• you lived in Wales and started your postgraduate
master’s course on or after 1 August 2017
• you lived in England or Wales and started your postgraduate doctoral course on or after 1 August 2018

Yes I Have Plan 1

Yes I Have Plan 2

Yes I Have Plan 4

Yes I Have A Postgraduate Loan

Declaration

I confirm that the information I’ve given on this section is correct.

Full Name

Date

Terms of Engagement for Agency Workers

Please download and keep for your records

I confirm I have read and understood the Terms of Application and agree to the Terms of Engagement for Agency Workers (Contract for Services) should I opt to be paid through PAYE methods (Required)

Yes

Temporary Worker Handbook

Please download and keep for your records

I confirm I have read and understood the temporary worker handbook and fully understand the following: Health and Safety at Work Basic Food Hygiene Manual Handling Holidays – How they are accrued and taken

Yes

Opt-Out of 48 Hour Working Week Agreement

se download and keep for your records

I agree to opt out of the working time regulations 1998

Yes

Data Protection Act

The information that you have provided on this form, and on any CV given, will be used by Staff Central to provide you employment finding services. In providing this service to you, you consent to your personal data being included on a computerised database and consent to us transferring your details to our clients. We may check the information collected with third parties or with other information held by us. We may also use or pass to third parties’ information to present or detect crime, to protect public funds, or in other ways permitted or required by law

I have read and agree to how my data is stored by Staff Central

Yes

register with staff central

Personal Details

Employment Details

Employment History

Referees

Previous Agencies

Additional Information

Employee Statement

Student Loans

Declaration

Terms of Engagement for Agency Workers

Temporary Worker Handbook

Opt-Out of 48 Hour Working Week Agreement

Data Protection Act