Register - M&M Supply

Name *

Title *

Previous Names

Address *

Address Line 1

City

State / Province / Region

Postal Code

Email *

National Insurance Number *

Please choose the role you're registering for: *

Support Staff
Teacher

Phone *

Date of Birth *

Emergency Contact

Next of Kin or Emergency Contact *

Relationship to you *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Phone *

Experience

Please give a brief summary of your previous experience

Work Eligibility

Are you eligible to work in the UK? *

Type of Visa / Work Permit

Visa Expiry Date

Qualifications

Qualification *

University

Date obtained *

Degree Subject

Employment History

Name of Employer *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Dates From *

Job Title *

To *

Salary/Rate Per Day *

Reason for Leaving *

Would you like to add an additional employer?

Name of Employer

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Dates From

Job Title

Salary/Rate Per Day

Reason for Leaving

Would you like to add an additional employer?

Name of Employer

Address

Address Line 1

City

State / Province / Region

Postal Code

Dates From

Job Title

Salary / Rate Per Day

Reason for Leaving

References - Please give details of 2 referees

Referee 1

Name *

Position *

Phone *

Company *

Email *

Referee 2

Name *

Position *

Phone *

Company *

Email *

Type of Work

What type of work are you looking for? *

Short Term
Long Term
Permanent

Required Rate / Salary *

Type of Work

Criminal Record & Security Checks (where applicable)

A criminal record check from the Disclosure and Barring Service may be required.

Do you hold a Disclosure and Barring Service check or overseas police check within the last 3 years? *

Have you ever been convicted of a criminal offence which is not spent under the Rehabilitation of Offenders Act 1974? *

Do you have any convictions, cautions, reprimands or final warnings that are not "protected" as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013) *

If yes, please give details:

UK Residence

Please state any periods of residence outside your country of origin within the last 5 years and any periods of more than 12 months at any time.

Interview and Assessment

Are there any adjustments that need to be made for you to attend an interview or undertake an assessment as part of an interview process? *

Declaration

Confirmation *

I confirm that the information provided on this form and within my CV, if applicable, is both truthful and accurate. I have omitted no facts that could affect my future employment. I understand that any engagement entered into is subject to documentary evidence of my right to work in the UK, verification of any professional qualifications and, in the case of temporary assignments, subject to satisfactory references. I expressly consent to any sensitive or personal data, disclosed as part of my application, being used in connection with the search for work, subject to the relevant Data Protection legislation. I will inform M&M Supply immediately of any circumstances that may affect my work, such as changes to health, subsequent pending prosecutions or convictions, which may arise whilst I am registered for permanent or temporary work.

Consent to Share Information *

I confirm that I am happy for M&M Supply to share my details with relevant schools and other educational institutions for job opportunities.

Signature *

Clear Signature

Name *

Date *