Lynx Employment Services Ltd.

Application Form

Personnel Details Position Applied For: ______

Date: / Mr/Mrs/Miss/Ms / How did you hear about Lynx?
Forename: / Surname: / Nat Ins no:
Address:
Post Code: / Telephone No: / Mobile No:
Do you hold a current driving licence? Yes No
What Class of Licence do you hold? Car Motorbike LGV Class
Do you have your own Transport? Yes No
Do you have any unspent criminal convictions or cases pending? Yes No
If yes give details?
Would you be prepared to complete a DBS (Police Check) Yes No
Lynx Employment actively works with the HOME OFFICE and identification is
regularly checked.
Are you eligible to work within the UK? Yes No
If yes please note that you will be required to produce your National Insurance details/passport/work permit or other relevant documentation, when you start working with us.

Health and Disability

The following questions on health and disability are asked in order to find out your needs in terms of reasonable adjustments to access our recruitment service and to find out your needs in order to perform the job or position sought.

Do you have any health issues or a disability relevant to the position or role you seek? Yes/No

(Please delete clearly as appropriate)

If yes, please specify ……………………………………………

If you have a disability, what are your needs in terms of reasonable adjustments to enable you to perform the role sought?

Please specify………………………………………………

If you have a disability, what are your needs in terms of reasonable adjustments in order to access this recruitment service and to attend interview, or to take aptitude tests etc?

Please specify………………………………......

Education History

School/College/University / From: / To / Qualifications / Grade

Bank Details

Bank Name / Account Holders Name:
Address: / Sort Code:
Account Number:
Building Society Ref:
I hereby give you authorisation to pay my wages into the bank account above

Criminal Convictions (Please delete clearly as appropriate)

Do you have any unspent* criminal convictions? Yes/No

If yes, state convictions and dates ………………………………………………………

*Certain types of employment and professions are exempt from the Rehabilitation of Offenders Act 1974 and in those cases particularly where the employment is sought in relation to positions involving working with children or vulnerable adults, details for all criminal convictions must be given. The information given will be treated in the strictest of confidence and only taken into account where, in the reasonable opinion of Lynx Employment Services Ltd, the offence is relevant to the post to which you are applying. Failure to declare a conviction may require us to exclude you from our register or terminate an assignment if the offence is not declared but later comes to light.

Permission to work in the UK

Do you have immigration permission to work in the UK? Yes/No

(Delete clearly as appropriate)

In line with Home Office guidance on the prevention of illegal working we will need to verify and take a copy of your original ID documentation as evidence of your right to work in the UK if you are to be engaged by Lynx Employment Services Ltd. for temporary work.

Work History - for the last 10 years (most recent first)

Company Address:
Post Code:
Tel No: / From:
To: / Rate of Pay:
Job title & Duties
Reason for Leaving: / Office Use Ref Check:
Company Address:
Post Code:
Tel No: / From:
To: / Rate of Pay:
Job title & Duties
Reason for Leaving: / Office Use Ref Check:
Company Address:
Post Code:
Tel No: / From:
To: / Rate of Pay:
Job title & Duties
Reason for Leaving: / Office Use Ref Check:
Company Address:
Post Code:
Tel No: / From:
To: / Rate of Pay:
Job title & Duties
Reason for Leaving: / Office Use Ref Check:
Company Address:
Post Code:
Tel No: / From:
To: / Rate of Pay:
Job title & Duties
Reason for Leaving: / Office Use Ref Check:
Company Address:
Post Code:
Tel No: / From:
To: / Rate of Pay:
Job title & Duties
Reason for Leaving: / Office Use Ref Check:
Company Address:
Post Code:
Tel No: / From:
To: / Rate of Pay:
Job title & Duties
Reason for Leaving: / Office Use Ref Check:
Company Address:
Post Code:
Tel No: / From:
To: / Rate of Pay:
Job title & Duties
Reason for Leaving: / Office Use Ref Check:

Equal Opportunities Statement

Lynx Employment Services Ltd. is committed to a policy of equal opportunities for all work seekers and shall adhere to such a policy at all times and will review on an on-going basis on all aspects of recruitment to avoid unlawful or undesirable discrimination. We will treat everyone equally irrespective of sex, sexual orientation, marital status, age, disability, race, colour, ethnic or national origin, religion, political beliefs or membership or non-membership of a Trade Union and we place an obligation upon all staff to respect and act in accordance with the policy.

Lynx Employment Services Ltd. shall not discriminate unlawfully when deciding which candidate/temporary worker is submitted for a vacancy or assignment, or in any terms of employment or terms of engagement for temporary workers. Lynx Employment Services Ltd. will ensure that each candidate is assessed only in accordance with the candidate’s merits, qualification and ability to perform the relevant duties required by the particular vacancy.

To help us to monitor the effectiveness of our policy please complete the details below, or if you would like to do this anonymously a separate sheet can be provided.

THIS INFORMATION WILL NOT FORM PART OF OUR RECRUITMENT DECISION.

Do you consider yourself to have a disability? YES NO

If yes please give details

Do you think that adjustments to our recruitment process or to the job role may be required to accommodate your disability?

YES NO

(If yes, a member of our team will contact you to discuss your requirements)

Date of birth: Age:

Gender: Female/Male

Martial Status: Single/ Married / Separated / Divorced / Widowed / Other / No. of dependents under 18 years of age: / If so, how many are living at your address:

Religion/Belief:

Please indicate your ethnic origin:

o  Black-African / o  White (inc Greek or Turkish) / o  Indian
o  Black-Caribbean / o  Irish / o  Pakistani
o  Black-Other (inc-mixed parentage) / o  Chinese / o  Bangladeshi

Other (Inc Arab, Iranian, other mixed origin) Please specify ______

Please indicate your religion:

o  Christian / o  Jewish
o  Hindu / o  Buddhist
o  Sikh / o  Muslim

Other please specify ______

Please indicate your Sexual Orientation:

o  Bisexual / o  Transsexual
o  Heterosexual / o  Transvestite
o  Homosexual / o  Other

Referees

Please provide the name, address and telephone number of previous employment and/or training for a minimum of three years previous (five preferable). These must include your most recent employer and a previous employer. If self employed please give business reference. References will be applied for covering the last five years of employment. Your current employer will not be contacted until an offer has been made. If you have been overseas for a single spell of three months or more, references from overseas are relevant.

Name______Name______

Company______Company______

Head office address______Head office address______
______

______

Name______Name______

Company______Company______

Head office address______Head office address______
______

______

Name______Name______

Company______Company______

Head office address______Head office address______
______

______

Data Protection Statement

The information that you provide on this form and on any CV given will be used by Lynx Employment Services Ltd. to provide you work 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 personal 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 certain third parties information to prevent or detect crime, to protect public funds, or in other way permitted or required by law.

DECLARATION

I confirm that the information given on this application form to join Lynx Employment Services Ltd. is correct to the best of my knowledge.

I understand that any engagement entered into is subject to a satisfactory probationary period, references satisfactory to the company, documentary evidence of my national insurance number and my right to work in the UK and, if necessary, a medical assessment via a written form.

I verify that the information provided is accurate, true and complete. I understand, if I am appointed and this information is found to be inaccurate, untrue or incomplete, that this will be treated as gross misconduct and may render me liable to dismissal.

I understand that the information I have provided will be used in accordance with the data protection act 1998 for the purpose of my application for employment with Lynx Employment Services Ltd. I understand that this information will be used to process my application and report on equal opportunities and other areas of personnel and staff administration necessary to promote Lynx Employment Services business. Should I require a copy of this information, I understand that I need to contact the data controller in the Sheffield office.

I hereby confirm that the information given is true and correct. I consent to my personal data and CV being forwarded to clients. I consent to references being passed onto potential employers.

If, during the course of a temporary assignment, the Client wishes to employ me direct, I acknowledge that Lynx Employment Services Ltd. will be entitled either to charge the client an introduction/transfer fee, or to agree an extension of the hiring period with the Client (after which I may be employed by the Client without further charge being applicable to the Client).

Signed: ………………………………………. Date: ………………………………

Internal Use Only

Tax Status: / Forms Required: / Comments:
PAYE: / P45
Unemployed or No P45: / P46
Student: / P38
Employee Number:
Input By: / Date: / Checked By: / Date:

DATE OF COMMENCEMENT ………………………………………………………………………