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CANDIDATE REGISTRATION FORM
PERSONAL DETAILS
Salutation
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Mr
Mrs
Miss
Ms
Dr
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Forenames
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Surname
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Email
Date of Birth
NI Number
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Telephone number (Mobile)
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Address Line 1
Town/City
County
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Postcode
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Nationality
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Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Ireland
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
The Democratic Republic of Congo
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
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Right To Work in the UK?
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Yes
No
Visa Type (If applicable)
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Full UK Driving License?
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Own Car?
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Yes
No
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Upload Passport ID OR UK Birth Certificate
Choose file
Upload Share Code (if applicable)
Choose file
CAREER SEARCH DETAILS
Desired Job Roles
Preferred Industry
Employment Type
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Casual
Contract
Part Time
Permanent
Temporary
Temporary to Permanent
Preferred Work Location(s) (1)
Salary Requirement
Frequency
Hour
Day
Week
Month
Year
Willing to relocate?
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Yes
No
Notice Period
Select Date
Immediate
Select Notice Period
1 Week
2 Weeks
3 Weeks
4 Weeks
1 Month
2 Months
3 Months
4 Months
5 Months
6 Months
Key Skills
Language spoken
Arabic
French
German
Hindi
Italian
Japanese
Polish
Portugese
Punjabi
Russian
Turkish
Romanian
Dutch
TEMPORARY WORK (if applicable)
Desired Temp Roles
Preferred Work Hours
Date Available
Preferred Work Location(s) (2)
ADDITIONAL INFORMATION
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Do you have any unspent criminal convictions?
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Yes
No
If yes, please provide details confidentially
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Do you require any reasonable adjustments for interviews or the workplace?
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Yes
No
If yes, please provide details
Willing to relocate:
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Yes
No
REFEREES
Name (1)
Address (1)
E-mail (1)
Telephone No. (1)
Relationship to you (1)
Name (2)
Address (2)
E-mail (2)
Telephone No. (2)
Relationship to you (2)
DECLARATION
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I confirm that the information provided above is accurate and complete to the best of my knowledge. I understand that providing false or misleading information may affect my application. I consent to my details being stored and processed by the recruitment agency in accordance with GDPR regulations.
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I confirm that I have read, understood, and agree to Anne Corder Recruitment's Privacy Policy, which can be viewed here:
Privacy Policy
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