Private Development Page (Register With Us) – Active (Pathways) Solutions Ltd

First Name (required field)

Last Name (required field)

Street Address

Address Line 2

City

Post Code

Email Address (required field)

Home Phone Number

Mobile Phone Number

Date of Birth

National Insurance Number

Emergency Contact Name

Emergency Contact Number

Contact Name

Company Name

Can we contact this person now?
YesNo

Reference Street Address

Reference Address Line 2

Reference City

Reference Postcode

Reference Phone Number

Reference Email Address

Contact Name

Company Name

Reference Street Address

Reference Address Line 2

Reference City

Reference Postcode

Reference Phone Number

Reference Email Address

Can we contact this person now?
YesNo

Do you have any unspent criminal convictions
YesNo

If yes, please specify

See more information about criminal conviction

Criminal Convictions

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 Active Solutions UK 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.

We are required to check that you are eligible to work in the UK.
Please confirm whether you are a:
British citizenCitizen of other European Economic Area EEA1) countryCitizen of other country

Please enter the name of the country

See more information about permission to work in the UK

Permission to work in the UK

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 Active Solutions UK Ltd for temporary work.

If you require a Visa, please provide details below, and attach supporting documentation at the bottom of the form.

Qualifications (Please list all qualifications/authorisations that you hold and that are in date) i.e. CSCS, ECS, Safety Passport etc.)

Do you have any health issues or a disability relevant to the position or role you seek?
YesNo

See more information about health and disability

Health and Disability

The 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.

If yes, please specify

Do you have diabetes needing insulin?
YesNo
Do you suffer from epilepsy or fits?
YesNo
Have you ever suffered blackouts, recurrent dizziness or any condition which may cause sudden collapse or incapacity?
YesNo
Do you get discomfort or pain in the chest or shortness of breath on exercise (e.g. climbing a single flight of stairs)?
YesNo
Do you have high or low blood pressure
YesNo
Are you taking any medication that is causing you dizziness or drowsiness?
YesNo
Do you take regular medication? Please give details below
YesNo
Do you have problems with heights?
YesNo
Are you capable of repetitive lifting as required for the employment
YesNo
Do you have any difficulty with your eyesight (other than the wearing of glasses or contact lenses where required)? E.g. colour blindness
YesNo
Have you ever had heart problems?
YesNo
Have you ever had a serious accident or operation?
YesNo
Do you have any difficulty hearing normal conversation?
YesNo
Do you suffer from back or neck problems?
YesNo
Would being on your feet all day cause you a problem?
YesNo
Have you had a hernia?
YesNo
Have you had any illness related to alcohol during the last 12 months?
YesNo
Have you used any drug of abuse (not alcohol or tobacco) within the last 12 months?
YesNo

Attach CV (accepted filetypes include DOC and PDF)

Attach Authorisations / Certifications (accepted filetypes include DOC and PDF)

Attach Supporting Documents (accepted filetypes include DOC and PDF)

See more information about equal opportunities

Active Solutions UK 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.

Active Solutions UK 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. Active Solutions UK 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.

I hereby give my consent to the Company to process the following information:

Personal data

Name
Date of birth
Contact details, including telephone number, email address and postal address
Experience, training and qualifications
CV
National insurance number

Sensitive personal data

Disability/health condition relevant to the role
Criminal conviction

I consent to the Company processing the above personal data for the following purposes:

For the Company to provide me with work-finding services.
For the Company to process with or transfer my personal data to their clients in order to provide me with work-finding services.
For the Company to process my data on a computerised database Red Rabbit Software in order to provide me with work-finding services.

I also consent to the Company processing my personal data with third parties including The REC, The EAS Inspectorate, Achilles and Alcumus ISOQAR for the purposes of internal audits and investigations carried out on the Company to ensure that the Company is complying with all relevant laws and obligations.

The consent I give to the Company will last for 6 years.

I am aware that I have the right to withdraw my consent at any time by informing the Company that I wish to do so.

(By entering your name you are hereby legally signing this consent form)

Please enter today's date

See more information about data protection

Data Protection Statement

The information that you provide on this form and on any CV given will be used by Active Solutions UK 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 present or detect crime, to protect public funds, or in other way permitted or required by law.

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 clients. If, during the course of an assignment, the Client wishes to employ me direct, I acknowledge that Active Solutions UK 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).

I confirm that the above information is true and correct (required field)

(By entering your name you are hereby legally signing this agreement)

Signed Date (required field)

BY SIGNING AND SUBMITTING THIS DOCUMENT YOU ARE ACKNOWLEDGING AND ACCEPTING OUR TERMS AND CONDITIONS

This form is to be completed in full prior to contract engagement via Active (Pathways) Solutions Ltd

Criminal Convictions

Permission to work in the UK

Health and Disability

Data Protection Statement