To register or apply to work with Etiquette Recruitment and Staffing Ltd you will need the following documents. If you do not have these you will not be able to complete the mandatory fields of this application form. If you would like to speak with a member of our team before proceeding please call 01332 895 984
If you have answered
No to any of the above and therefore cannot provide proof then it is likely we will not review the submitted application if it is a mandatory requirement for the position you are applying for. Please ensure that you have accurately answered all of the above.
Personal Details Required
Many of the fields are mandatory and should be completed fully. If you have answered
Yes in the Compliance Section you must provide the details and/or upload copies of the files.
Please complete in block capitals stating your full name as it appears on your professional registration and passport
Entitlement to Work in the UK I CONFIRM THAT I AM ENTITLED TO WORK IN THE UK AND WILL PROVIDE ETIQUETTE RECRUITMENT AND STAFFING LTD WITH THE RELEVANT ORIGINAL DOCUMENTS IN ACCORDANCE WITH THE ASYLUM AND IMMIGRATION ACT, PLEASE CONFIRM YES OR NO.
Pre Offenders Declaration
Because of the nature of work for which you are applying, this post is exempt from the provisions of section 4.2 of the rehabilitation pf offenders act1974 (exemption order 1975). You are required to declare prosecutions or convictions, including those considered ‘spent’ under this act.
Have you been convicted of a criminal offence, been found bound over or cautioned or are you currently the subject of any police investigations which might lead to a conviction, an order binding you over a caution in the UK or any other country?
IF Yes, please provide details
If yes, please provide outline in box below the criminal offence, order binding you over, a caution, including approximate date, the offence and the authority and country which dealt with the offence.
Security Clearance Details
If you answered Yes, please provide details:
Proceedings Undertaken If yes please provide information in the box below detailing the nature of the proceedings undertaken, or contemplated, including approximate date of proceedings, country where proceedings were undertaken and the name and address of the licencing of regulatory body concerned.
P.A.Y.E payment information for P.A.Y.E workers only – please ensure this is completed correctly
I CONFIRM THE DETAILS I HAVE PROVIDED REGARDING MY BANK DETAILS ARE CORRECT ND I ACCEPT THAT ALL MY PAYEMENTS SHOULD BE MADE INTO THE ABOVE ACCOUNT UNLESS OTHERWISE STATED IN WRITING ETIQUETTE RECRUITMENT AND STAFFING LTD.
Etiquette Recruitment and Staffing Ltd requires professional references covering at least the last three years (without gaps). The names references should be of a senior position to you and business addresses are essential. By submitting this information, you hereby consent to Etiquette Recruitment and Staffing Ltd making contact with these persons to obtain references. One reference covering the last five years (without gaps) is also acceptable
Medical Assessment Detail
Answers to this questionnaire will be kept confidential by the occupational health department and information you give will not be handed to anyone else without your written consent
The purpose of this questionnaire is to examine your current health status in order to establish what effect this might have upon your ability to undertake duties of your current/offered post and/or whether issues you may have, present any issues to yourself and/or others in the workplace.
We may recommend adjustments or assistance as a result of this assessment to better enable you to do your job. Our aim is to promote and maintain the health of all people at work. Before health clearance is given for employment, you may need to be seen by an occupational health nurse or physician please complete this questionnaire as fully as possible, in black pen and block capitals.
Medical: Personal Details
Personal Details for the purpose of a Medical Assessment.
Please answer the following questions. Any further details to specific questions can be answered at the end of this section especially if you have answered yes to any of the answers.
Summary Medical Questions
Summary Medical Questions
In the following section, please give details of any of the questions, which you have answered
Details which may be useful to include:
How long did you have this problem for?
When was this?
If any, what type of treatment did you receive?
Were you admitted to hospital, unable to work or prevented from carrying out your normal activities because of the problem? Does the condition continue to affect you in any way?
Immunisation / Blood Tests
Please provide evidence of immunisation/blood test results (if applicable) for the following, it must be stamped or signed by your GP, occupational health (oh) provider
You may be asked to provide documentary evidence for the following.
Documentary evidence of BCG vaccination
History of BCG vaccination (scar evident)
Documentary evidence of Mantoux test within last five years. Chest x ray result if relevant.
Declaration DECLARATION ANS SUBMISSION
DECLARATION AND CONSENT
AS PART OF YOUR EMPLOYEMENT WITH ETIQUETTE RECRUITMENT AND STAFFING LTD WE MAY NEED TO CONTACT YOU BEFORE HEALTH CLEARANCE IS GIVEN FOR EMPLOYMENT BY AN OCCUPATIONAL HEALTH NURSE (OHN) OR AN OCCUPATIONAL HEALTH PHYSICIAN (OHP)
I UNDERSTAND THAT MY PERSONAL DETAILS WILL BE HANDED IN ACCORDANCE WITH THE DATA PROTECTION ACT 1998.
YOU ARE ADVISED THAT THE DISCLOSED INFORMATION ABOVE WILL BE HELD ON COMPUTER AND/OR MANUAL RECORDS. IT WILL NOT BE DISCLOSED TO ANYONE OUTSIDE ETIQUETTE RECRUITMENT AND STAFFING LTD AND ITS OCCUPATIONAL HEALTH DEPARTMENT WITHOUT YOUR WRITTEN PERMISSION. ANY NOMINATED TEMPORARY WORKER WHO PROCESSES MY INFORMATION WILL OBSERVE THE NORMAL RULES REGARDING CONFIDENTIALITY AS DEFINED WITHIN THE DATA PROTECTION ACT 1998
IF I HAVE WILLINGLY WITHHELD ANY RELEVANT MEDICAL DETAILS, I REALISE I MAY BE SUBJECT TO DISCIPLINARY ACTION. I GIVE MY CONSENT TO ETIQUETTE RECRUITMENT AND STAFFING LTD AND ITS OCCUPATIONAL HEALTH DEPARTMENT TO ASSESS MY FILE.
I DECLARE THAT THE INFORMATION GIVEN IN THIS APPLICATION FORM IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. I HAVE READ AND UNDERSTOOD THE TERMS OF ENGAGEMNT BOOKLET. I AGREE TO COMPLY WITH THE CURRENT HEALTH AND SAFTEY WORK ACT. I UNDERSTAND THAT MY APPOINTMENT IS SUBJECT TO THE RECIPET OF A MNIMUM OF 2 SATISFACTORY REFERENCES AND IS SUBJECT TO DISCLOUSRE. I AUTHORISE ETIQUETTE RECRUITMENT AND STAFFING LTD MAKE ANY FUTHER ENQUIRIES THEY MAY FEEL NECESSARY TO SUPPORT MY APPLICATION. I AGREE TO RESPECT THE CONFIDENTIALITY OF PATIENTS AND CLIENTS AND OTHER INFORMATION I MAY HAVE ACCESS TO AT ALL TIMES.
CHOOSING TO SUBMIT THE INFORMATION PROVIDED WE WILL TREAT THE SUBMISSION WITH NAME AND DATES AS ELECTRONIC SIGNATURES. WE MAY ASK YOU TO SIGN A COPY OF THE PAPERWORK IF REQUESTED TO ATTEND AN INTERVIEW.