Your details are already registered with this agency, you will need to contact the agency direct to re-register your details.
1. SECTION 1 - 48 Hour Opt-Out Agreement

I agree that the limit regulation 4(1) of the Working Time Regulations 1998 shall not apply to me and that my average working week may therefore exceed 48 hours for each 7 day period (as defined by and calculated in accordance with the Working Time Regulations 1998).

This agreement shall apply from the date below and I agree that I will comply with any and all policies of the employment business, from time to time, which relate to its maintenance of records of my hours of work. If I change my mind, I will give X2 Recruit one week’s notice in writing to end this agreement.

2. SECTION 2 - Health Statement

We need to ensure that we do not place you in a position or on an assignment where we could potentially compromise your health and safety.

Do you have any medical condition or disability which could render an assignment unsuitable.
3. SECTION 2 - Health Statement

If you have answered YES please give details regarding this. 

4. SECTION 2 - Health Statement

Are there any medical reasons, or are you currently taking any medication, that will affect your ability to work any shifts?
5. SECTION 2 - Health Statement

If you have answered YES please give details regarding this. 

SECTION 3 - Drug and Alcohol Policy

1. X2 Recruit has a zero-tolerance policy for candidates working under the influence of drugs and alcohol.

2. X2 Recruit conducts random drug and alcohol testing on all of our sites.

3. Any X2 Recruit candidate found to be under the influence of drugs or alcohol whilst on assignment for X2 Recruit may have their assignment cancelled.

4. The Company has not the internal resources to provide or arrange treatment or other forms of specialist assistance.

6. SECTION 4 - Criminal History

Do you have any “live” or “unspent” convictions under the Rehabilitation of Offenders Act 1974?
7. SECTION 4 - Criminal History

If you have answered YES please give details regarding this. 

8. SECTION 5

I confirm that I have been issued with the X2 Recruit Agency Workers Terms of Engagement (Contract for Services).These Terms are governed by the law of England & Wales/Scotland and are subject to the exclusive jurisdiction of the Courts of England & Wales.
9. SECTION 6

I hereby give consent for X2 Recruit to process my personal data and pass my details to my employer, hirer or any other 3rd party as deemed applicable  to fulfil contractual obligations as necessary.
10. Declaration 

Please complete the following declaration and sign it in the appropriate place below.

If this declaration is not completed and signed, your application will not be considered:

I agree that X2 Recruit Ltd can create and maintain computer and paper records of my personal data and that this will be processed and stored in accordance with the General Data Protection Regulation 2018. I confirm that all the information given by me in this form is correct and accurate and I understand that if any of the information I have provided is later found to be false or misleading any offer of temporary work may be withdrawn or temporary assignment terminated. I confirm that I understand the above policy in relation to working time and drug/alcohol abuse. I hereby certify that the answers given in this questionnaire are complete and true to the best of my knowledge. I know of no health reasons in relation to my legal rights under the Disability Discrimination Act 1995 which will affect my ability to undertake the duties of the post for which I am applying. 

Key Information Document. 

This document sets out key information about your relationship with us, including details about pay, holiday entitlement and other benefits.

Further information can be obtained from X2 Recruit.

The Employment Agency Standards (EAS) Inspectorate is the government authority responsible for the enforcement of certain agency worker rights. You can raise a concern with them directly on 020 4566 5333 or through the Acas helpline on 0300 123 1100, Monday to Friday, 8am to 6pm.

General Information

Name of Employment Business  - X2 Recruit

Your employer (if different from the employment business) -  X2 Recruit Ltd

Type of contract you will be engaged under -  Contract for Services

Who will be responsible for paying you (if different from your employer) -  N/A

How often you will be paid -  Weekly

Expected or minimum rate of pay - At least the prevailing or current National Living Wage or National Minimum Wage, as appropriate Deductions from your pay required by law PAYE tax, Employee National Insurance Contributions, Employee pension contributions - 5% of gross pay (if no opt out), Student Loan (if applicable)

Any other deductions or costs from your pay (to include amounts or how they are calculated)  - None

Any fees for goods or services -  If a DBS is required we will charge a one off fee of £35.70-£63.70 (Basic-Enhanced). £12 per week if you want Early Wage Access

Holiday entitlement and pay -  Statutory holiday entitlement of 5.6 weeks, pro rated for part time work. Holiday pay is accrued and paid when time off is taken.

Additional benefits -  N/A

Example Pay Example rate of pay £13.00 per hour x 40 hours per week = £520.00

Deductions from your wage required by law - PAYE Tax - £55.60, National Insurance Contributions - £22.24, Pension - £26.00, Student loan (if applicable) - £3.60 (Based on tax code 1257L)

Any other deductions or costs from your wage -  None

Any fees for goods or services -  DBS charge (If applicable) - £35.70, Early Wage Access fee (If applicable) - £12 Example net take home pay £364.86

1. Please enter your Name
2. Date of Signature
3. Signature