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Previous names
Please add any names you were previously known by
Previous addresses
Please provide all of the addresses you have lived in prior to your current address for the last 5 years. This should include any overseas addresses and student accommodation, where applicable.
Aberdeenshire
Angus
Antrim
Armagh
Avon
Ayrshire
Bedfordshire
Berkshire
Borders
Buckinghamshire
Cambridgeshire
Carlow
Cavan
Channel Islands
Cheshire
Clackmannanshire
Clare
Cleveland
Clwyd
Cork
Cornwall
County Durham
Cumbria
Derbyshire
Devon
Donegal
Dorset
Down
Dumfries & Galloway
Dunbartonshire
Dyfed
East Lothian
East Sussex
Essex
Fermanagh
Fife
Galway
Gloucestershire
Greater London
Greater Manchester
Guernsey
Gwent
Gwynedd
Hampshire
Hereford
Hereford & Worcester
Hertfordshire
Highland
Humberside
Inverclyde
Isle of Man
Isle of Wight
Isles of Scilly
Jersey
Kent
Kerry
Kildare
Kilkenny
Lanarkshire
Lancashire
Laois
Leicestershire
Leitrim
Limerick
Lincolnshire
Londonderry
Longford
Louth
Mayo
Meath
Merseyside
Mid Glamorgan
Middlesex
Midlothian
Monaghan
Moray
Norfolk
North Yorkshire
Northamptonshire
Northumberland
Nottinghamshire
Offaly
Orkney
Oxfordshire
Perth & Kinross
Powys
Renfrewshire
Roscommon
Shetland
Shropshire
Sligo
Somerset
South Glamorgan
South Yorkshire
Staffordshire
Suffolk
Surrey
Tipperary
Tyne & Wear
Tyrone
Warwickshire
Waterford
West Glamorgan
West Lothian
West Midlands
West Sussex
West Yorkshire
Western Isles
Westmeath
Wexford
Wicklow
Wiltshire
Aberdeenshire
Angus
Antrim
Armagh
Avon
Ayrshire
Bedfordshire
Berkshire
Borders
Buckinghamshire
Cambridgeshire
Carlow
Cavan
Channel Islands
Cheshire
Clackmannanshire
Clare
Cleveland
Clwyd
Cork
Cornwall
County Durham
Cumbria
Derbyshire
Devon
Donegal
Dorset
Down
Dumfries & Galloway
Dunbartonshire
Dyfed
East Lothian
East Sussex
Essex
Fermanagh
Fife
Galway
Gloucestershire
Greater London
Greater Manchester
Guernsey
Gwent
Gwynedd
Hampshire
Hereford
Hereford & Worcester
Hertfordshire
Highland
Humberside
Inverclyde
Isle of Man
Isle of Wight
Isles of Scilly
Jersey
Kent
Kerry
Kildare
Kilkenny
Lanarkshire
Lancashire
Laois
Leicestershire
Leitrim
Limerick
Lincolnshire
Londonderry
Longford
Louth
Mayo
Meath
Merseyside
Mid Glamorgan
Middlesex
Midlothian
Monaghan
Moray
Norfolk
North Yorkshire
Northamptonshire
Northumberland
Nottinghamshire
Offaly
Orkney
Oxfordshire
Perth & Kinross
Powys
Renfrewshire
Roscommon
Shetland
Shropshire
Sligo
Somerset
South Glamorgan
South Yorkshire
Staffordshire
Suffolk
Surrey
Tipperary
Tyne & Wear
Tyrone
Warwickshire
Waterford
West Glamorgan
West Lothian
West Midlands
West Sussex
West Yorkshire
Western Isles
Westmeath
Wexford
Wicklow
Wiltshire
Aberdeenshire
Angus
Antrim
Armagh
Avon
Ayrshire
Bedfordshire
Berkshire
Borders
Buckinghamshire
Cambridgeshire
Carlow
Cavan
Channel Islands
Cheshire
Clackmannanshire
Clare
Cleveland
Clwyd
Cork
Cornwall
County Durham
Cumbria
Derbyshire
Devon
Donegal
Dorset
Down
Dumfries & Galloway
Dunbartonshire
Dyfed
East Lothian
East Sussex
Essex
Fermanagh
Fife
Galway
Gloucestershire
Greater London
Greater Manchester
Guernsey
Gwent
Gwynedd
Hampshire
Hereford
Hereford & Worcester
Hertfordshire
Highland
Humberside
Inverclyde
Isle of Man
Isle of Wight
Isles of Scilly
Jersey
Kent
Kerry
Kildare
Kilkenny
Lanarkshire
Lancashire
Laois
Leicestershire
Leitrim
Limerick
Lincolnshire
Londonderry
Longford
Louth
Mayo
Meath
Merseyside
Mid Glamorgan
Middlesex
Midlothian
Monaghan
Moray
Norfolk
North Yorkshire
Northamptonshire
Northumberland
Nottinghamshire
Offaly
Orkney
Oxfordshire
Perth & Kinross
Powys
Renfrewshire
Roscommon
Shetland
Shropshire
Sligo
Somerset
South Glamorgan
South Yorkshire
Staffordshire
Suffolk
Surrey
Tipperary
Tyne & Wear
Tyrone
Warwickshire
Waterford
West Glamorgan
West Lothian
West Midlands
West Sussex
West Yorkshire
Western Isles
Westmeath
Wexford
Wicklow
Wiltshire
Aberdeenshire
Angus
Antrim
Armagh
Avon
Ayrshire
Bedfordshire
Berkshire
Borders
Buckinghamshire
Cambridgeshire
Carlow
Cavan
Channel Islands
Cheshire
Clackmannanshire
Clare
Cleveland
Clwyd
Cork
Cornwall
County Durham
Cumbria
Derbyshire
Devon
Donegal
Dorset
Down
Dumfries & Galloway
Dunbartonshire
Dyfed
East Lothian
East Sussex
Essex
Fermanagh
Fife
Galway
Gloucestershire
Greater London
Greater Manchester
Guernsey
Gwent
Gwynedd
Hampshire
Hereford
Hereford & Worcester
Hertfordshire
Highland
Humberside
Inverclyde
Isle of Man
Isle of Wight
Isles of Scilly
Jersey
Kent
Kerry
Kildare
Kilkenny
Lanarkshire
Lancashire
Laois
Leicestershire
Leitrim
Limerick
Lincolnshire
Londonderry
Longford
Louth
Mayo
Meath
Merseyside
Mid Glamorgan
Middlesex
Midlothian
Monaghan
Moray
Norfolk
North Yorkshire
Northamptonshire
Northumberland
Nottinghamshire
Offaly
Orkney
Oxfordshire
Perth & Kinross
Powys
Renfrewshire
Roscommon
Shetland
Shropshire
Sligo
Somerset
South Glamorgan
South Yorkshire
Staffordshire
Suffolk
Surrey
Tipperary
Tyne & Wear
Tyrone
Warwickshire
Waterford
West Glamorgan
West Lothian
West Midlands
West Sussex
West Yorkshire
Western Isles
Westmeath
Wexford
Wicklow
Wiltshire
Aberdeenshire
Angus
Antrim
Armagh
Avon
Ayrshire
Bedfordshire
Berkshire
Borders
Buckinghamshire
Cambridgeshire
Carlow
Cavan
Channel Islands
Cheshire
Clackmannanshire
Clare
Cleveland
Clwyd
Cork
Cornwall
County Durham
Cumbria
Derbyshire
Devon
Donegal
Dorset
Down
Dumfries & Galloway
Dunbartonshire
Dyfed
East Lothian
East Sussex
Essex
Fermanagh
Fife
Galway
Gloucestershire
Greater London
Greater Manchester
Guernsey
Gwent
Gwynedd
Hampshire
Hereford
Hereford & Worcester
Hertfordshire
Highland
Humberside
Inverclyde
Isle of Man
Isle of Wight
Isles of Scilly
Jersey
Kent
Kerry
Kildare
Kilkenny
Lanarkshire
Lancashire
Laois
Leicestershire
Leitrim
Limerick
Lincolnshire
Londonderry
Longford
Louth
Mayo
Meath
Merseyside
Mid Glamorgan
Middlesex
Midlothian
Monaghan
Moray
Norfolk
North Yorkshire
Northamptonshire
Northumberland
Nottinghamshire
Offaly
Orkney
Oxfordshire
Perth & Kinross
Powys
Renfrewshire
Roscommon
Shetland
Shropshire
Sligo
Somerset
South Glamorgan
South Yorkshire
Staffordshire
Suffolk
Surrey
Tipperary
Tyne & Wear
Tyrone
Warwickshire
Waterford
West Glamorgan
West Lothian
West Midlands
West Sussex
West Yorkshire
Western Isles
Westmeath
Wexford
Wicklow
Wiltshire
Work/Education History details
Please ensure that the information provided is true and correct and can be verified by references from previous employers.
Where do your skills lie?
Let us know what you're good at so that we can find the right job for you.
Accounts Assistant
Accounts Payable
Apprentice
AS400
Assistant Buyer
Bookkeeper
Budget Analysis
CAD
Commercial Administrator
Credit Control
Credit Controller
Credit Manager
Customer Service
Data Input
Design
Direct Sales
Driving Administrator
Marketing
Office Manager
Office Supervisor
Purchase Ledger
Purchasing
Reception
SAGE
Sales Ledger
ADR
CPC
Curtain Sider
DIGI Tacho
Flat Bed
HIAB
Moffett
Shunter
Tramper
Vehicle Transporter
Bendi
Counterbalance
CXT/TUG
FLT
HLOP
LLOP
PPT
Reach
Scissor Lift
VNA
Cleaner
Goods in / out
Loader
Order Picker
Packer
Quality Control
Reworker
Stock Check
Storeman
Unloader
Warehouse Administrator
Grounds Maintenance
Inspection Technician
Inspector Packer
Labourer
Security Guard
Surface Finishing Technician
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.
All temporary workers have a duty under the Health and safety Act to take reasonable care to avoid injury to themselves or to others by their work activities and to co – operate with the client and others in meeting statutory requirements. The Act requires Temporary Workers not to interfere with or misuse anything provided to protect their Health, Safety or Welfare in Compliance with the Act (Section 7 & 8)
You will be required to take all reasonable steps to safeguard your own safety and the safety of anyone who may be affected by your actions whilst working on a temporary assignment for Industria Personnel Services.
It is your responsibility to familiarise yourself with the information on Health & Safety, First Aid, Accidents and Fire Procedures upon arrival at the Client.
Yes
No
Yes
No
Criminal Record Disclosure
Before completing this section please read our policy regarding candidates with criminal convictions. We are asking you to complete this form in relation to job roles which are not exempt from the Rehabilitation of Offenders Act 1974. For this reason you are only required to disclose information about unspent convictions. You are not required to disclose spent convictions on this form.
Additionally, you are not required to declare any information about ‘protected’ offences – (offences to which the filtering rules apply). If you are unsure as to whether a conviction is unspent/spent or protected (filtered) please see the additional guidance or you can contact organisations such as NACRO or Unlock for further information.
If you wish to be put forward for/if any role is identified which may be suitable for you but which is exempt from the Rehabilitation of Offenders Act 1974, meaning that you are required to disclosure spent convictions, we will ask you to complete an additional criminal disclosure form. You are not required to complete that additional form if you do not wish to be put forward for that type of work.
You are not required to provide any information about protected (filtered) offences. If you have declared any convictions you are welcome to provide us with any additional information that you think may be relevant and which will help us to determine your suitability to be put forward for roles with our clients, this could include for example information about the circumstances of that offence, any work (paid or voluntary) or training that you have undertaken since, change in your circumstance etc.
We will seek to put forward/supply the best possible candidates to our clients. Having a criminal conviction will not necessarily exclude you from the process.
The information given will be treated in the strictest of confidence and only taken into account where, in our reasonable opinion, 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 if the offence is not declared but later comes to light. If you are working in an assignment with a client at the time that we are made aware of a conviction that you have not disclosed to us, we may be legally required to inform our client of that information and your assignment may be terminated.
Yes
No
Bank Details
Please only provide details if you are the account holder. Industria Personnel and our payroll providers are only able to make payments into bank/building society accounts in your name.
Agree
Disagree
Right to Work
Please select the link for guidance on acceptable right to work documentation, located
here
, and upload the required proofs below.Please note, the field below allows you to upload multiple files. To do so, please click the field and select all of the files you want to upload in one go.
Documentation
Proof of name change (if applicable) - this must be for every name change you have had. We can accept Birth Certificate, Marriage Certificate or Deed poll.
GDPR Statement
Industria Personnel provides work-finding services to its clients and work-seekers. We must process personal data (including sensitive personal data) so that we can provide these services. This is why we have asked for your personal data on this form. When we process your personal data we must do so in accordance with data protection laws. Those laws require us to give you a Privacy Statement to explain how we manage your personal data. This is attached to this application pack.
HMRC Starter Checklist
As a new employee your employer needs the information on this form before your first payday to tell HMRC about you and help them use the correct tax code.
This is my first job since 6 April and I’ve not been receiving taxable Jobseeker’s Allowance, Employment and Support Allowance, taxable Incapacity Benefit, State or Occupational Pension.
This is now my only job but since 6 April I’ve had another job, or received taxable Jobseeker’s Allowance, Employment and Support Allowance or taxable Incapacity Benefit. I do not receive a State or Occupational Pension.
As well as my new job, I have another job or receive a State or Occupational Pension.
Yes
No
Plan 1
Plan 2
Plan 4
Postgraduate Loan (England & Wales only)
Candidate Declarations
Agree
Agree – KID PAYE
Agree
Agree
Agree – Terms of Business PAYE
Agree (Opt in)
Disagree (Opt Out)
Agree
I can confirm I haven’t paid any money to be introduced to Industria
I can confirm I have paid money to be introduced to Industria
Agree
Agree
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