REGISTER WITH US – Temp Personnel

Full Name:

Address:

Telephone Number:

SEX:

Date of birth:

Nation Insurance number (NINO)

Emergency Contact

Nationality

Please list any companies that you have worked for through agency in the last 8 weeks (optional)

Please tick if you suffer from below

Diabetes

Epilepsy

Heart Problems

None of the above

Please tick ONE that applies to you:

I do not know of any health conditions or disability's that will affect my ability to complete assignments for Temp Personnel

I do know of any health conditions or disability's that will affect my ability to complete assignments for Temp Personnel

By signing your name below you confirm that the above information is correct

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