1. Please choose the statement which best describes your circumstances:

1. This is your first job since last 6th April and you have not been receiving taxable Jobseekers Allowance, Employment and Support Allowance, taxable Incapacity Benefit, State Pension or Occupational Pension.

2. This is now your only job, but since last 6th April you have had another job, or have received taxable Jobseekers Allowance, Employment and Support Allowance or taxable Incapacity Benefit. You do not receive State or Occupational Pension.

3. You currently have another job or receive a state or occupational pension *

1. Do you have any illnesses / disabilities? *

2. Please tell us about your illnesses or disabilities.

Please enter NA if this does not apply to you *

1. Do you have any allergies? *

2. Please tell us about your allergies.

Please enter NA if this does not apply to you

*

1. Do you have any previous warehouse or production experience? Please tick all that apply *

1. Do you have any convictions? *

2. What was you convicted of and what was the date of your conviction?

Please enter NA if this does not apply to you *

1. Work Time Directive - 48 Hour Maximum Working Week This agreement is made between Resilient Recruitment Limited and the Worker. AGREEMENT: The Working Time Regulations 1998 provide the the average working week, including overtime, shall not exceed 48 hours. by signing this agreement the Company and the Worker agree the the limit to working hours shall not apply to the Worker. This agreement will remain in force indefinitely or until such time as the Company or the Worker terminate the agreement. Written notification must be given to terminate this agreement. *

2. Supply of Goods and Services.   This agreement is made between Resilient Recruitment Limited and the Worker. AGREEMENT: I hereby authorise Resilient Recruitment Limited to deduct any expenses arising from the supply of transport and work wear from any monies owing to me, where Resilient Recruitment Limited have provided such goods and/or services.   *

3. Final Declarations & Agreement - AGREEMENT: I hereby certify the information I have provided in the document is true and to the best of my knowledge. I authorise Resilient Recruitment Limited to use any or all of this information in conjunction with my application for work placements. I confirm I have received and understood a Resilient Recruitment Registration Pack. *