Application Form

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It’s easy to register simply fill in and complete your details online below. If we have a position that suits your profile we will be in contact to let you know the good news!

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Your Details
Education
Driving
Opt Out Agreement
Health Assessment
Health & Safety
Bank Details
Company Declaration
Driver Declaration

APPLICATION/REGISTRATION FORM

TEMPORARY/PERMANENT/BOTH (please delete as applicable)

Surname

Address

Home Phone

D.O.B

Nationality

Next of Kin

Address

Forenames

Postcode

Mobile Phone

Email *

N.I. No

Relationship

Phone No

Personal References: Please give the name & address of someone who has known you for at least 5 years, who is NOT a relative, who can give you a personal reference:

Name

Address

Phone No

Relationship

Post Code

Do you hold a full drivers licence?

Driving Licence Number

Are you eligible to work in the UK?

Do you have your own transport?

Right To Work Share Code

Is your health good?

(delete as applicable)

Have you ever had treatment for diabetes, epilepsy, heart disease, any form of blackout or any contagious disease?

(delete as applicable)

If yes please give full details:

Do you require any special adjustments to your working environment?

(delete as applicable)

If yes, what are they?

Do you have any allergies?

(delete as applicable)

If yes, what are they?

Do you wear spectacles?

(delete as applicable)

Would you agree to a medical examination?

(delete as applicable)

Schools and colleges attended: (please state below)

Continuous previous employment for the last 5 years (minimum):
Please give Names/ Address & Phone Number for all employers giving the most recent first

Company

Date to

Phone No / Email

Contact

Date from

Position

Address

Reason for leaving

Company

Date to

Phone No / Email

Contact

Date from

Position

Address

Reason for leaving

Company

Date to

Phone No / Email

Contact

Date from

Position

Address

Reason for leaving

Company

Date to

Phone No / Email

Contact

Date from

Position

Address

Reason for leaving

Company

Date to

Phone No / Email

Contact

Date from

Position

Address

Reason for leaving

Company

Date to

Phone No / Email

Contact

Date from

Position

Address

Reason for leaving

Do you hold any of the following?

LGV /PCV/PSV Licence

Class

Date passed

Forklift Licence

(please list type of license held)

Type

ADR Dangerous substances certificate

Aviation Security Certificate Level

(delete as applicable)

Other relevant qualifications

Have you ever held a British Airports Authority Pass?

If yes, which Airport was it issued

What areas were you permitted to enter?

Was the pass returned at the end of your employment?

If no, state the reason why:

Have you ever been convicted for a criminal offence (including outside the UK)?

If yes, please give full details: (you must declare convictions that are not spent under the provisions of the Rehabilitation of Offenders Act 1974)

PLEASE READ CAREFULLY:

I understand that it is an offence under the Aviation & Maritime Security Act 1990, to give false information regarding my application for employment with Invicta Staffing Ltd.

I declare that the information given in this application form is true, accurate and complete.

I understand that if I have given any misleading information on this form or made any omissions, this will be sufficient grounds for terminating or refusing further consideration to be given to my employment.

I will notify Invicta Staffing if I receive any endorsements on my driving licence. Failure to notify the company will breach my Contract with Invicta Staffing.

I understand and agree that Invicta Staffing will make approaches to former employers, educational establishments, government agencies and personal referees for verifications of the information I have given.

Applicant’s Signature

Date

The information provided by you on this form as an applicant will be stored either on paper records or a computer system in accordance with the Data Protection Act 1998 and will be processed solely in connection with recruitment.

WTR OPT OUT AGREEMENT FOR TEMPORARY WORKERS.

(Hereinafter called the Employment Business) acting as an agent for the client.

And

Hereinafter called the temporary workers.

1.DEFINITION

1.1 In this agreement the following definitions apply.
Assignment means the period which the temporary worker is engaged to render services to the client. Client means the person, firm or corporate body engaging the service of the temporary worker. Working week means an average of 48 hours each week calculated over 17 week references period. Night Hours as determined by the WTR (a) HGV – 00:00 to 04:00 (b) PCV – 01:00 to 05:00
1.2Reference to the singular include the plural and reference to the masculine include the feminine and vice versa.
1.3 It is agreed that the agency and the employees will adopt the flexibility permitted by the Working Times Regulations (a) Night Workers: a night worker's normal hours of work may exceed the limit of 10 hours in each 24-hour period.

2.RESTRICTION

2.1The working time regulations 1998 provide that the temporary worker shall not work on an assignment with the client in excess of the working week unless he agrees in writing that the limit should not apply.

3.CONSENT

3.1The temporary worker hereby agrees that the working week limit should not apply to the assignment

4.WITHDRAWAL OF CONSENT

4.1The temporary worker may end this agreement by giving 3 months notice in writing
4.2For avoidance of doubt, any notice bringing this agreement to an end shall not be constructed as termination by the temporary worker of an assignment with the client.
4.3Upon expiry of the notice period set out in clause 4.1 the working week limit shall apply with immediate effect

5.THE LAW

5.1These terms are governed by English Law and are subject to the exclusive jurisdiction of the English courts

Signed

Date

HEALTH SELF ASSESSMENT DECLARATION FOR DAY & NIGHT WORKERS

In compliance with the working time regulations the purpose of this declaration is to assess your fitness to carry out work whilst in assignment for

Whilst there is no difference in the physical demands of night work compared to day work the human body is naturally programmed to sleep at night. The distribution to this pattern can aggravate certain medical conditions, albeit often temporary, additionally the reduced access to the services and facilities may be apparent both inside and outside the workplace.

Please answer the following questions: if your answers raise doubts about your fitness for night work, then unfortunately you may not be assigned to clients for night work unless you are able to provide proof that are physically able to do so having been assessed by a fully qualified health care professional.

Do you have any health concerns that you feel may prevent you from working at night? If YES are these based on:

a) Requirement to take medication (tablets, insulin, injections etc) on a strict timetable

b) Heart or circulatory problems that could be aggravated by additional stress required stamina that night work may require.

c) Stomach or intestine disorders where the regularity/timings of meals are important

d) Medical conditions that affect the ability to sleep during the day or are affected by changing sleep patterns

e) Chronic chest or respiratory disorders whose nighttime symptoms are significantly worse than in the daytime

f) Any other health related problem

g) Are you aged under 18

If you have indicated YES to any of the above points, please enter specific details

I fully understand that this declaration may be submitted to or viewed by any prospective client to whom I may be assigned in order that I may undertake night work

Name

Date

Signed

TEMPORARY WORKER HEALTH & SAFETY DECLARATION

All employers must have a health and safety policy stating who is responsible for health and safety and the health and safety programs in place. It is your responsibility to familiarise yourself with the policy, particularly the proceeds upon arrival at the clients premises. All temporary workers have a duty under the health and safety act to take responsible care to safeguard their own safety and the safety of anyone who may be affected by their work activities and actions and to co-operate with the client and others in meeting statuary regulations. The client also requires the temporary worker not to interfere with or misuse anything provided to protect their health, safety and welfare in compliance with the act.

Information should be available on the following as appropriate

Noise at work regulation
Provision and use of work equipment and regulations (PUWER) 1998 Health & Safety Manual handling operations regulations 1992 The fire precautions (workplace) regulations 1997 Personal protective equipment (PPE) regulations 1992
Control of substance hazardous to health and safety regulations (COSHH) 2002
Workplace (Health and Welfare) regulations 1992

Signed

Date

BANK DETAILS

Account Name

Address

Account No

Leaving Date

Bank/Building Society Name

Sort Code

Building Society Reference

Reason for Leaving

WORK PREFERENCES

Please select your work preferences

Please select a minimum of 3

Days
Nights
Weekends
Nights Out
HIAB
ADR
Roller Bed
Trunking
Tramping
Fridge
Double Decks
Airport
London
Tipper
Multidrop - 10
Multidrop - 20
Multidrop - 30
Multidrop - 40
Multidrop - 50
Multidrop - 60+

Invicta Staffing Ltd (‘the Company’)
Consent Declaration

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

Sensitive personal data

Disability/health condition relevant to the role
Criminal conviction, including the carrying out of criminal records checks.
Release of References of employment dates for compliance under CAA guidance

I consent to the Company processing the above sensitive 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 in order to provide me with work-finding services.

The consent I give to the Company will last for 3 years after they have ceased providing work-finding services.

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.

Signed by candidate / temporary worker

Date

DRIVERS DECLARATION FORM

(TO BE COMPLETED BY ANY APPLICANTS REGISTERING FOR DRIVING WORK FROM VAN TO HGV/PCV)

1. Have you been convicted of any motoring offence (Within the last 5 years)

If yes, please give details

2. Have you in the last 10 years had your license suspended or revoked?

If yes, please give details

3. At the date of signing this form is there any prosecutions pending or has anything occurred which may result in future prosecution?

If yes, please give details

4. Have you had any road traffic accidents in the last five years?

If yes, please give details

5. Have you suffered from any illness in the last five years that has affected your ability to be employed as a driver?

If yes, please give details

I will inform INVICTA STAFFING LIMITED of anything that occurring which may affect my driving ability.

I will inform INVICTA STAFFING LIMITED of the hours I have worked in a 24 hour period, should I take any work in any capacity outside of this on my own behalf or of any person or company I shall notify INVICTA STAFFING LIMITED immediately as this may affect future positions with the company.

I hereby acknowledge that whilst being paid by INVICTA STAFFING LIMITED on behalf of the person or company which INVICTA STAFFING LIMITED introduce me to as a employee, I will be and will remain during the term of each and every assignment the employee of the person or company to whom I am introduced and at all times I will be under the direction and control of each and every employer as to what I do and the manner of which this is done.

SIGNED (DRIVER)

PRINT NAME

Date

Name

Invicta Staffing

Targeting the Right Candidate

Looking for something new?

APPLICATION/REGISTRATION FORM

TEMPORARY/PERMANENT/BOTH (please delete as applicable)

Do you hold any of the following?

PLEASE READ CAREFULLY:

WTR OPT OUT AGREEMENT FOR TEMPORARY WORKERS.

HEALTH SELF ASSESSMENT DECLARATION FOR DAY & NIGHT WORKERS

TEMPORARY WORKER HEALTH & SAFETY DECLARATION

BANK DETAILS

WORK PREFERENCES

Invicta Staffing Ltd (‘the Company’)
Consent Declaration

DRIVERS DECLARATION FORM

(TO BE COMPLETED BY ANY APPLICANTS REGISTERING FOR DRIVING WORK FROM VAN TO HGV/PCV)

Got a question?

Looking for something new?

APPLICATION/REGISTRATION FORM

TEMPORARY/PERMANENT/BOTH (please delete as applicable)

Do you hold any of the following?

PLEASE READ CAREFULLY:

WTR OPT OUT AGREEMENT FOR TEMPORARY WORKERS.

HEALTH SELF ASSESSMENT DECLARATION FOR DAY & NIGHT WORKERS

TEMPORARY WORKER HEALTH & SAFETY DECLARATION

BANK DETAILS

WORK PREFERENCES

Invicta Staffing Ltd (‘the Company’)Consent Declaration

DRIVERS DECLARATION FORM

(TO BE COMPLETED BY ANY APPLICANTS REGISTERING FOR DRIVING WORK FROM VAN TO HGV/PCV)

Got a question?

Invicta Staffing Ltd (‘the Company’)
Consent Declaration