This registration form collects personal and employment details from applicants, including name, address, qualifications, work history, availability, and health information. It notes the company's equal opportunity and diversity policies. Applicants must declare any criminal convictions or medical issues. By signing, applicants agree the company can process their data, contact references, and understand site safety policies. The form is used to assess applicants for roles and compliance with legal and regulatory requirements.

1. REGISTRATION FORM
POSITION APPLIED FOR:
PAST WORK EXPERIENCE:
PERSONAL DETAILS:
Title: Forename Surname:
Address: Face Book:
Linked In:
Email:
Postcode: Tel No: Mobile:
Date of Birth: NI No:
UTR:
Nationality: Work Permit Required? Yes  No 
Transport: Bus  Train  Underground  Full UK License  Any endorsements? yes  No 
P.P.E: S/T Boots  Hat  Hi-Vi  Gloves  Goggles 
AVAILABILITY: Mon □ Tue □ Wed □ Thur □ Fri □ Sat □ Sun □
NEXT OF KIN:
Name: Relationship:
Tel. No.:
QUALIFICATIONS & TRAINING DETAILS
CSCS : Carded  Applied for Card  Passed Test  Applied for test  No CSCS  Reg. No: _______________________
WORK HISTORY:
Date Agency , Phone & Description of Rate Company Worked at Name Reported to Contact Number
To - From contact Name Duties Paid on site & Email

2. DIVERSITY POLICY
This company practices Equal Opportunity in employment and has a statement of Policy to that effect. The company is
committed to monitoring the effectiveness of the policy in respect of job applicants and employees in accordance with the
codes of Practice issued by the Commission for Racial Equality, the Equal Opportunities Commission and the Code of Practice
relating to the Disability Discrimination Act. Information in this section will not be passed to third parties, other than in
appropriate circumstances. Employees will have access to their recorded data
CRIMINAL CONVICTIONS YES NO EQUAL OPPORTUNITY DETAILS YES NO
Have you ever been convicted of a criminal Do you consider yourself to have a disability?
offence?
If ‘yes’ Please give details (Under The Rehabilitation of Offenders If ‘yes’ Please give details of the effects of the disability and of
Act 1974, spent convictions need not be declared) any assistance you require to enable you to carry out the duties of
the job
HEALTH YES NO
Do you have any medical illness?
Are you on any medication?
Do your fingers go white / numb when cold? CRIMINAL RECORDS BUREAU
Do you suffer from tingling in the hands? Have you completed a CRB Check in the past? Y N
Do you suffer from lack of grip in the hands? If yes, please specify: Enhanced Standard
Do you have any pain in wrist or arm? Serial No: Issue Date:
Do you feel that you have lost sensitivity in the
fingers? HEALTH & SAFETY
Have you noticed you now struggle with fiddly or
fine tasks?
Do you wear glasses or contact lenses?
Have you been issued and understood
Do you use drugs of abuse?
SiteMasters Health & Safety Policy?
Have you ever had any alcohol related illness?
If you have answered ‘yes’ to any of the above please give details: Are you in agreement to attend site inductions?
Do you take responsibility to read any notices
made available to you in respect of Heath &
DECLARATION
I understand that misrepresentation, falsification or omission of information requested on this application form may be cause for
dismissal. Prior to any offer of work being made I understand that I shall provide documentary evidence of my eligibility to work in the
U.K. I consent to the company recording my data and disclosing information contained on this form to third parties. I also consent to the
company contacting my present and/or previous employer for a reference.
Applicants Signature: Date:
FOR OFFICE USE ONLY
INTERVIEWERS NOTES
Card Referral Prompt 
TSI Prompt 
Sell back 
CHECK LIST on file Expiry A B C Dt
Passport / Birth Cert / ID card Personality
Proof of eligibility to work in UK Availability
UTR Appearance
NI Ease of Travel
CSCS (Letter or Card)
References
Interviewed by:
Signed H & S Policy
Signed Declaration Signature:
Date