Online Application Form - Expedient Recruitment

Date of Application

1. Your Personal Information

Your Name*

Address*

Home Tel Number

Mobile*

Email*

Date of Birth*

Marital Status*

Sex*

Nationality*

Specify Nationality*

Place of Birth*

Form of ID*

How did you hear about Expedient?

Please specify*

Do you have your own Transport?*

Yes
No

Education

Tick Level Achieved/Studied

GCSE
A/AS Level
Higher Education

Please give details

Work Experience

Most recent employment first

Employer 1

Job Title	Name of Supervisor/Referee	Company Name

Company Address

Company Tel Number

Date Employed From

Date Employed To

Job Description

Employer 2

Job Title	Name of Supervisor/Referee	Company Name

Company Address

Company Tel Number

Date Employed From

Date Employed To

Job Description

Employer 3

Job Title	Name of Supervisor/Referee	Company Name

Company Tel Number

Company Address

Date Employed From

Date Employed To

Job Description

Is Expedient Recruitment Ltd able to approach the above for a reference?

Yes
No

If No, please give a reason why*

What agencies have you worked for?

What companies did the agencies send you to?

Equal Opportunities Statement

Expedient Recruitment 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.

Expedient Recruitment 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. Expedient Recruitment 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.

Criminal Convictions

Do you have any unspent* criminal convictions?*

Yes
No

*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 Expedient Recruitment 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.

If Yes, state convictions and dates*

Permission to Work in the UK

Do you have permission to work in the UK?*

Yes
No

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 Expedient Recruitment Ltd for temporary work.

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

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?

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?

Data Protection Statement

The information that you provide on this form and on any CV given will be used by Expedient Recruitment Ltd to provide you work finding services. In providing this service to you, you consent to your personal data being included on a computerized 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 present or detect crime, to protect public funds, or in other way permitted or required by law.

We will keep your information indefinitely on our data base, however, if you wish for your data to be destroyed you must confirm this in writing.

Candidate Declaration

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. I understand that should information be found to be incorrect, this may jeopardize any offer of employment from Expedient Recruitment Ltd.

If, during the course of a temporary assignment, the Client wishes to employ me direct, I acknowledge that Expedient Recruitment 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 by Candidate*

2. Medical Health Questionnaire

Please complete this confidential questionnaire.

Your Name*

Your Address*

Date of Birth*

Registered Disabled?*

Yes
No

Registration Number*

Are you fit and well?*

GP's Name

Title Forename Surname

GP's Address

GP's Tel Number

Do you have, or have you ever suffered from any of the following?
Please tick Yes or No

Heart Trouble*

Yes
No

Lung Disease*

Yes
No

Stomach/Bowel Trouble*

Yes
No

Jaundice/Hepatitis*

Yes
No

Joint Problems*

Yes
No

Diabetes*

Yes
No

Allergies*

Yes
No

Headaches/Migraines*

Yes
No

Severe Stress Reaction*

Yes
No

Serious Accident*

Yes
No

High Blood Pressure*

Yes
No

Asthma*

Yes
No

Hernia or Rupture*

Yes
No

Kidney/Bladder Disorder*

Yes
No

Back/Neck Problems*

Yes
No

Fits/Blackouts/Epilepsy*

Yes
No

Mental Health Problems*

Yes
No

Hearing/Sight Problems*

Yes
No

Skin Problems*

Yes
No

Surgical Operations*

Yes
No

Have you any disability affecting any of the following?
Please tick Yes or No

Ability to Drive a Motor Vehicle*

Yes
No

Standing*

Yes
No

Working at Heights*

Yes
No

Lifting*

Yes
No

Walking*

Yes
No

Use of Hands*

Yes
No

Climbing Stairs*

Yes
No

In the last 3 years have you been off work because of illness of injury?*

Yes
No

If yes, how many working days did you lose?*

Are you at present having treatment or medicine described by a doctor?*

Yes
No

If yes, what?*

Have you made a full recovery from your illness injury?*

Yes
No

If you have answered yes to any of the above questions, please give full details*

Candidate Declaration

I declare that the answers to the above questions are accurate to the best of my knowledge and understanding. I consent to Expedient Recruitment Ltd obtaining further information about any of the above conditions that I have disclosed in this questionnaire from any doctor and/or hospital by which I have been treated.

Signed by Candidate*

3. Ability Testing Questions

Your Name*

Date of Birth*

Visual Accuracy

The column on the left is correct; please compare the right hand column and insert the number of errors, if any, in the appropriate box provided.

Mathematics
Select the correct answers

1. Multiply 7 x 48*

2. Subtract 17 from 86*

3. What is the total weight of 8 parcels each weighing 4 kg and 3 parcels each weighing 11 kg?*

4. If 8 items are packed in a case, how many items are there in 13 cases?*

5-7. Add the following*

86 + 39 =	149 + 52 =	26 + 1077 =

8-9. Add the following*

20 + 37 + 129 =	14 + 77 + 8 + 195 =

10-12. Subtract the following*

347 - 199 =	85 - 48 =	1671 - 1591 =

13-15. Subtract the following*

146 minus 97 =	249 minus 186 =	200 minus 39 =

16-17. Calculate the following*

12 x 4 plus 9 =	23 x 3 plus 17 =

18-20. Divide the following*

84 ÷ 12 =	130 ÷ 5 =	132 ÷ 12 =

Visual Accuracy
21-24. For the following questions look at the description on the top and identify the exact duplicate below. Select the appropriate answer.

X + BO FYG.PTO.FOB.LIST.730*

X + BO.FYG PTO.FOB.LIST 730
X + BO.FYG.PTO FOB.LIST.730
X + BO FYG.PTO.FOB.LIST.730

S/SOFT SHAMPOO AIR 750ml*

S/SOFT SHAMMPO AIR 730ml
S/SOFT SHAMPOO AIR 750 nl
S/SOFT SHAMPOO AIR 750ml

3551333.9754*

3551133.9754
3551333.9754
3551333.9574

320/1797/40.32*

320/1797/4032
320/1997/40.32
320/1797/40.32

Logic
25-27. Re-arrange the following into alphabetical or numerical order

P B R S F C M*

L J C N F T K*

14, 41, 23, 19, 6, 34, 16*

Logic
28-29. Identify the missing number in the sequence

3, 6, 9, 12, ??, 18*

30, 24, ??, 12, 6, 0*

30. Which one of these things does a man always possess?*

Hat
Children
Heart
Motor-car
Wife

31. An office employs 9 men, 28 women and 10 boys. How many people work there altogether?*

32. Which of these activities is the odd one out?*

Football
Cricket
Rugby
Chess
Bowls

33. With what letter does the last word but one in the sentence that you are reading begins? Write as a capital letter*

For Question 34, please write the following amount in words.*

34. £1,995

For Question 35, please write the following amount in numbers*

35. Three thousand, four hundred and twenty three

Thank you for completing this assessment

4. 48 Hour Opt Out Agreement

1. Definitions

1.1. In this Agreement the following definitions apply: “Agency Worker” means;
“Assignment” means the period during which the Agency Worker is supplied to provide services to the Client;
“Client” means the person, firm or corporate body using the services of the Agency Worker;
“Employment Business” means Expedient Recruitment Ltd, registered company number 6443810 of 12-14 Warwick Street, Earlsdon, CV5 6ET
“Working Week” means an average of 48 hours each week calculated over a 17-week reference period.

1.2. References to the singular include the plural and references to the masculine include the feminine and vice versa.
1.3. The headings contained in this Agreement are for convenience only and do not affect their interpretation.

2. Restriction

The Working Time Regulations 1998 (as amended) provide that the Agency Worker shall not work on an Assignment with the Client in excess of the Working Week unless s/he agrees in writing that this limit should not apply.

3. Consent

The Agency Worker hereby agrees that the Working Week limit shall not apply to the Assignment.

4. Withdrawal of Consent

4.1. The Agency Worker may end this Agreement by giving the Employment Business 4 weeks notice in writing.
4.2. For the avoidance of doubt, any notice bringing this Agreement to an end shall not be construed as termination by the Agency Worker of an Assignment with a Client.
4.3. Upon the expiry of the notice period set out in clause 4.1 the Working Week limit shall apply with immediate effect.

5. The Law

This Agreement is governed by the law of England & Wales and is subject to the exclusive jurisdiction of the Courts of England & Wales

Signed by the Agency Worker*

5. New Starter Details

Your Name*

Address*

Email*

Date of Birth*

National Insurance Number*

Telephone Number (Home)*

Telephone Number (Mobile)*

Name of Contact in case of Emergency*

Telephone Number*

Bank Account Details

Sort Code*

Account Number*

Bank Name*

Account Name*

Please ensure that the details that you give are correct as your money will be paid into the account details given.

Declaration

I confirm that the above information is correct and freely given

Signature*

6. P46

Your Details

National Insurance Number*

This is very important in getting your tax and benefits right

Your Name*

Gender*

Date of Birth*

Address*

Your Present Circumstances

Read all the following statements carefully and select the one that applies to you.*

This is my first job since last 6 April and I have not been receiving taxable Jobseeker's Allowance, Employment and Support Allowance or taxable incapacity Benefit or a state or occupational pension.
This is now my only job, but since last 6 April I have had another job, or have received taxable Jobseeker's Allowance Employment and Support Allowance or taxable Incapacity Benefit. I do not receive a state or occupational pension.
I have another job or receive a state or occupational pension.

Student Loans (Advanced in the UK)

If the below statement applies to you, select the box

If you left a course of UK Higher Education before last 6 April and received your first UK Student Loan instalment on or after 1 September 1998 and you have not fully repaid your Student Loan

Do not select the box above if you are repaying your UK Student Loan by agreement with the UK Student Loans Company to make monthly payments through your bank or building society.

Declaration

I confirm that this information is correct

Signature*

7. Agency Worker Contract for Services

Between:
Expedient Recruitment Ltd (hereinafter referred to as the “company” or the “employment business”)

and

Your Name*

(hereinafter referred to as the “agency worker” or “you”.)

Nature of Engagement

The company will act as an employment business in respect of this agreement and will endeavour to find assignments for you.
The Employment Agencies Act 1973 prohibits the employment business from charging you a fee in respect of this work finding service.
The employment business does not provide any other goods or services in respect of which you may be charged a fee.
Work assignments will be offered to you on an "ad hoc" basis as and when the employment business matches you with suitable clients. You are free to accept or decline such assignments. You are not guaranteed continuous work and we are under no obligation to offer you further assignments. No contract shall exist between the employment business and yourself in periods between agreed work assignments.
Although you are free to engage in other work, if you already have or are considering any additional work, you should notify the employment business so that any implications arising from the current working time legislation can be discussed.
This contract for services and any attachments or particular assignment schedules do not therefore constitute a contract of employment between you and the employment business.
Assignments may be offered to you on an hourly, daily, weekly, or other basis. Attendance at work assignments will be in accordance with the assignment schedule for that particular assignment. When you have agreed to attend a work assignment and are unable to do so, you are required to notify a Director immediately.

Notification requirements to end an assignment

The employment business (or the client to whom you are assigned) may end an assignment at any time without prior notice or liability. You may terminate an assignment at any time by immediately informing the employment business.

Payment

The employment business reasonably expects to achieve a minimum of £ ……………per ……………for you. However, your actual payment in respect of any particular assignment may be more or less than the above amount and you will be notified of the applicable rate when you are offered any particular assignment.
You will become entitled to equal treatment under the Agency Workers Regulations 2010 with regard to pay after you have accrued 12 weeks in a particular role with a client organisation. Where this is the case, you will be advised separately of the relevant rate at the appropriate time. Please note that equal treatment does not relate to all aspects of pay.
You will be paid in respect of work done regardless of whether or not the employment business receives payment from the client to whom you are assigned.
Payment will be made weekly in arrears by bank credit transfer following submission of a properly completed time sheet. Statutory deductions such as income tax and NI contributions will be made from the payments.
Non-submission or incorrectly completed documentation may result in delayed payment. Any queries regarding payment should be raised with a Director.

Absence

Any absence, for whatever reason, whilst on an agreed assignment must be reported at the earliest opportunity on the day in question to enable alternative arrangements to be made. Notification should be made personally to a Director.
We do not operate a contractual sickness/injury payment scheme for agency workers.

Statutory Annual Leave

Your leave year is 1st January to 31st December.
You are entitled to paid annual leave in accordance with the relevant statutory provisions. For part years of service, entitlement will be calculated on a pro rata basis.
You will become entitled to equal treatment in relation to annual leave entitlement under the Agency Workers Regulations 2010 after you have accrued 12 weeks in a particular role with a client organisation. Where this is the case, you will be advised separately of the relevant entitlement at the appropriate time.
You should give at least four weeks’ written notice of your intention to take holidays of one week or more and one weeks’ written notice is required for odd single days. Such notice should be given to a Director.
The employment business will allocate agreed leave dates to take account of business needs and the arrangements made by other agency workers and our own employees to ensure operational efficiency. The employment business reserves the right to refuse leave requests if they conflict with the needs of the business and may, with due notice, require that you take your annual leave on specified dates.
Annual leave must be taken in the leave year in which it is accrued. You will not be allowed to “carry over” any annual leave into a subsequent leave year.
You will not be entitled to any payment for bank holidays or public holidays unless you are actually required to work them or they are taken as part of your statutory annual leave.
Payment in respect of statutory annual leave will be in accordance with the Working Time Regulations. In the event of the termination of your contract any annual leave accrued but not taken will be paid in lieu. However, in the event of your having taken more paid leave than you have accrued pro-rata, then the appropriate payments will be deducted from your final payment. This is an express written term of your contract for services.

Information about previous assignments

You shall inform us at the earliest possible opportunity prior to an assignment, or during each assignment, of any instances where you have worked, since 1st October 2011, in the same or similar role with the client or any member of the client’s group with whom we have placed you for assignment, via a third party. You shall provide us with details of such work and the periods during which it was carried out. You will comply with any reasonable requests we make for the provision of such information.

Health & Safety at Work

Under Health and Safety legislation each individual has a legal responsibility for their own welfare and for the health and safety of others. You must take all reasonable steps to safeguard your own safety and the safety of any other person who may be present and comply with the health and safety policies of any client to whom you are assigned.

Standards

You are under no obligation to accept an offer of an assignment, but if you do so, you agree, during every assignment and afterwards as appropriate, to observe the following conditions:

1. On attending a client’s establishment, you will observe any specific instructions given regarding standards of dress. Where no specific instructions have been given, you should present a professional image and wear clothes appropriate to the responsibilities of your assignment.
2. You will familiarise yourself with and observe any rules and regulations of the client’s establishment, particularly with regard to use of any computer equipment, client telephones and personal mobile phones.
3. You will not engage in any conduct detrimental to the interests of the client or the employment business.
4. You will co-operate with the client’s staff and accept the direction, instruction and supervision of any responsible person in the client’s establishment.
5. You will not at any time divulge to any person, nor use for your own or any other person’s benefit, any confidential information relating to the client’s or the employment business’ transactions, finances, customers, employees or business affairs.

Equal Opportunities

The employment business is committed to the principle of equality regardless of age, disability, gender reassignment, marriage and civil partnership, pregnancy or maternity, race, religion or belief, sex or sexual orientation. Policies will be applied that are fair, equitable and consistent with skills and abilities. You have a duty to support the employment business in implementing these policies to ensure equality of opportunity.

Complaining about Discrimination or Harassment

If you believe you are the victim of minor discrimination or harassment you should first make it clear to the discriminator/harasser that their behaviour is unwelcome and politely ask them to stop. If you feel unable to do this, or if this approach fails, or if the discrimination/harassment is more serious, you should discuss the matter with a senior employee of the employment business, who will endeavour to resolve the situation on your behalf.
If you agree to accept the above conditions, please sign and date both copies of this contract for services (retaining one for your own reference) and return one copy to a Director.

Pension Scheme

When required, we operate a contributory pension scheme to which you will be auto-enrolled into (subject to the conditions of the scheme). The scheme enables you to save for your retirement using your own money, together with tax relief and contributions from the company.

Yours sincerely
Darren Standbridge

For and on behalf of the employment business.

Declaration

I have read and understand the conditions relating to this work engagement and agree to my personal details being retained by the employment business for the purpose of matching me with suitable clients and contacting me with offers of ad hoc work assignments. I understand that this engagement, and any future work assignments will not indicate an employment relationship between the employment business and myself.

Signature*

8. Equal Opportunities Policy

A) Statement of Policy

1. The employment business recognises that discrimination is unacceptable. Equality of opportunity is a feature of our practices and procedures and we operate a formal equal opportunities policy. Breaches of the policy will lead to investigation and, if appropriate, further action.
2. The aim of the policy is to ensure that agency workers are not discriminated against either directly or indirectly on the grounds of age, disability, gender reassignment, marriage and civil partnership, pregnancy or maternity, race, religion or belief, sex or sexual orientation.
3. The employment business will ensure that the policy will be made available for all agency workers and made known to all applicants for work.
4. The policy will be communicated to all clients reminding them of their responsibilities towards equality of opportunity.
5. Whilst the employment business has no direct control over your place of work, we will endeavour to ensure that a neutral working environment is maintained, in which no agency worker feels under threat or intimidated.

B) Recruitment and Selection

2. A consistent and non-discriminatory approach will be taken to any advertising of vacancies.
3. Recruitment will not be confined to areas or media sources that provide only, or mainly, applicants of a particular group.
4. All applicants who apply for work will receive fair treatment and will be considered solely on their ability to do the work.
5. All employees involved in the recruitment, selection and assignment process will periodically review their selection criteria to ensure that they are related work requirements and do not unlawfully discriminate.
6. Interview questions will be related to the requirements of the work and will not be of a discriminatory nature.
7. The employment business will not disqualify any agency worker because he/she is unable to complete an application form unassisted unless personal completion of the form is a valid test of the standard of English required for the safe and effective performance of the type of work assignments being sought.
8. Selection decisions will not be influenced by any perceived prejudices of other staff.

Phone

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