LKA People Ltd T/A LKA Recruitment

Tribune House, 27 Sir Isaac’s Walk, Colchester, Essex CO1 1JJ

Tel: 01206 616 695 Co Reg: 11652486

APPLICATION FORM
Parcelforce Warehouse

Interviewed Date: Consult:

ID Card Date: Consult:
Security Check Date: Consult:
Reference 1 Date: Consult:
Reference 2 Date: Consult:
Availability Sheet Date: Consult:
Outlook Date: Consult:
Etips Date: Consult:
Payment Type Date: Consult:
CRM Date: Consult:
Items Scanned Date: Consult:
Date:
Date:
Fully Compliant Date: Manager:

Name

Personal Details
AJD/LKA/APPFORM 1
The following information is needed to process your application and will be kept private and confidential
First name / s:      
Surname:       Title:      
Gender – Male or Female:      
Place of Birth:       Nationality:      
NI Number:      
No. & Street:       Previous Address if less than 3 years
Town:            
County:            
Postcode:            
Mobile:       Other telephone:      
Email:      

Next of kin:       Relationship:      

Next of kin tel no.:      

Do you have any unspent criminal convictions? *Yes No

*If yes please give details:      

Note: Certain types of employment and professions are exempt from the Rehabilitation of Offenders Act 1974 and in those cases particularly where employment
is sought in relation to positions involving working with children or vulnerable adults, details of all criminal convictions must be given. The information will be
treated in the strictest confidence and only taken into account where, in the reasonable opinion of LKA Recruitment, the offence is relevant to the post for which
you are applying. Failure to declare a conviction may require us to exclude you from our register or terminate an assignment if the offence is not declared but
later comes to light.

Do you have immigration permission to work in the UK? Yes* No

In line with Home Office guidance on the prevention of illegal working we will need to verify and take a copy of your original ID documentation as evidence of
your right to work in the UK if you are to be engaged by LKA Recruitment for temporary work.
Are you working at the moment?

Are you working at the moment? Yes* No *If yes please give notice period:      
Available start date:      

Equal Opportunities
LKA Recruitment is committed to a policy of equal opportunities for all work seekers and shall always adhere to
such a policy and will review on an ongoing basis all aspects of recruitment to avoid unlawful or undesirable
discrimination. We will treat everyone equally irrespective of sex, sexual orientation, marital status, age, disability,
race, color, ethnic or national origin, religion, political beliefs or non-membership of a Trade Union and we place
an obligation upon staff to respect and act in accordance with the policy.

LKA Recruitment shall not discriminate unlawfully when deciding which candidate/temporary worker is submitted
for a vacancy or assignment, or in any terms of employment or terms of engagement for temporary workers. LKA
Recruitment will ensure that each candidate is assessed only in accordance with the candidate's merits,
qualification and ability to perform the relevant duties required by the vacancy.

Please detail your employment history starting with the most recent Covering 5 Years
1.

AJD/LKA/APPFORM 2
Company Name:      
Dates of Employment:      
Position Held:      
Duties:      
Can we contact them for a reference? *Yes No *If yes who is the contact:
Reason for leaving:      
Leaving salary / Hourly Rate:      
How did you get the position?       Do they use agencies?      
2.
Company Name:      
Dates of Employment:      
Position Held:      
Duties:      
Can we contact them for a reference? *Yes No *If yes who is the contact:
Reason for leaving:      
Leaving salary / Hourly Rate:      
How did you get the position?       Do they use agencies?      
3.
Company Name:      
Dates of Employment:      
Position Held:      
Duties:     
Can we contact them for a reference? *Yes No *If yes who is the contact:
Reason for leaving:      
Leaving salary / Hourly Rate:      
How did you get the position?       Do they use agencies?      

4.
Company Name:      
Dates of Employment:      
Position Held:      
Duties:      
Can we contact them for a reference? *Yes No *If yes who is the contact:
Reason for leaving:      
Leaving salary / Hourly Rate:      
How did you get the position?       Do they use agencies?      

Employment References
5 years of employment references must be provided below. These will be taken immediately
1.
Name:      
AJD/LKA/APPFORM 3
Company:      
Telephone Number:      
Capacity Known:      
2.
Name:      
Company:      
Telephone Number:      
Capacity Known:      
3.
Name:      
Company:      
Telephone Number:      
Capacity Known:      
4.
Name:      
Company:      
Telephone Number:      
Capacity Known:      

5.
Name:      
Company:      
Telephone Number:      
Capacity Known:      

6.
Name:      
Company:      
Telephone Number:      
Capacity Known:      

Agency Experience
Have you ever worked for another employment agency? Yes* No *If yes, please complete section below
Name of Agency (1)      
Please give details of Company Type of work Rate of Pay £
companies you have                  
AJD/LKA/APPFORM 4
 worked for through                  
this agency                  
Name of Agency (2)      
Please give details of Company Type of work Rate of Pay £
companies you have                  
worked for through                  
this agency                  
Name of Agency (3)      
Please give details of Company Type of Work Rate of Pay £
companies you have                  
worked for through                  
this agency                  

Travelling Distances
Please indicate where you would be willing to travel to
Do you have your own transport? *Yes No *If yes type of transport      
Will you travel to (tick all that are appropriate)?
Essex East Anglia London
East of England South UK UK
Europe Other      

Work Experience (Please complete area(s) of interest only.

We must provide PPE to work for certain clients, if you require PPE please fill in as appropriate in the boxes below.
If you have your own, please state so.
Safety Shoes Coat/Jacket/Hi-Vis Vest Trousers Safety Hat / Glasses
Yes No Yes No Yes No Yes No
Size       Size       Size       Size      

Preferred Hours / Job Type

Days Nights Weekends Comments      
Permanent Temporary Full Time Part Time

Declaration
Have you in the last 10 years had your license suspended? Yes * No
* If yes please give details:      

Have you in the last 5 years been convicted of any motoring offences? Yes * No
* If yes please give details:      

At the date of signing this form is there any prosecution or has anything occurred which
Yes * No
may result in a future prosecution?
* If yes please give details:      

Have you had any accidents in the last 7 years?

Yes * No

AJD/LKA/APPFORM 5
* If yes please give details:      

I have been explained about the payroll system and issued with a LKA Recruitment Code
of Conduct which has also been explained to me.
Print Name: Date:

Signature:

LKA Recruitment

Terms of Engagement of Temporary Workers

To be signed by temporary workers only

'Assignment means the period during which the Temporary Worker is supplied to
to the Client' render services.

'Client' means the person, firm or corporate body requiring the services of
the Temporary Worker.

'Employment Business' means LKA Recruitment, Tribune House, 27 Sir Isaacs Walk, Colchester, Essex,
CO1 1JJ

'Temporary Worker'
(Enter Name)      

1.2 Unless the context otherwise requires, references to the singular include the plural and references to
masculine include feminine and vice versa.

1.3 The headings contained in the terms are for convenience only and do not affect their interpretation.

5. THE CONTRACT
2.1 These Terms constitute a contract for services between the Employment Business and the Temporary Worker
and they govern all assignments undertaken by the Temporary Worker. However, no contract shall exist
between the Employment Business and the Temporary Worker between Assignments.

2.2 For the avoidance of doubt, these Terms shall not give rise to a contract of employment between the
Employment Business and the Temporary Worker. The Temporary Worker is engaged as a self-employed
worker, although the Employment Business is required to make statutory deductions from his remuneration in
accordance with clause 4.1.

2.3 No variation or alteration of Terms shall be valid unless approved by the Employment Business in writing and
with the agreement of the Temporary Worker.

3 ASSIGNMENTS
3.1 The Employment Business will endeavour to obtain suitable assignments for the Temporary Worker.

3.2 The Temporary Worker acknowledges that the nature of temporary work means that there may be periods
when no suitable work is available and agrees that the suitability shall be determined solely by the
Employment Business, and that the Employment Business shall incur no liability to the Temporary Worker
should it fail to offer opportunities to work in the above category or in any other category.

3.3 For the purpose of calculating the average number of weekly hours worked by the Temporary Worker on an
Assignment, the start date for the relevant average period under Working Time Regulations shall be 1st
October 1998 ore the date on which the Temporary Worker commences the first assignment, if later.

AJD/LKA/APPFORM 6
3.4 If, before or during an Assignment or during the Relevant Period, the Client wishes to Engage the Temporary
Worker directly or through another employment business, the Temporary Worker acknowledges that the
Employment Business will be entitled either to charge the Client a Transfer Fee or to agree a Period of
Extended Hire with the client at the end of which the Temporary Worker may be Engaged directly by the Client
or through another employment business without further charge to the Client. In addition, the Employment
Business will be entitled to charge a Transfer Fee to the Client if the Client introduces the Temporary Worker
to a third party who subsequently Engages the Temporary Worker within the Relevant Period

4. REMUNERATION
4.1 The Employment Business shall pay to the Temporary Worker remuneration at least the current National
Minimum Wage. The actual rate will be notified on a per Assignment basis, for each hour worked during the
Assignment (to the nearest quarter hour) to be paid weekly in arrears, subject to deductions in respect of PAYE
Class 1 National Insurance Contributions and Income Tax pursuant to S134 of the Income and Corporation
Taxes Act 1988 and any other deductions which the Employment Business may be required by law to make. If
bank details are provided, payment will be made via BACS, if no bank details are provided, payment will be
made by cheque.

4.2 Subject to any statutory entitlement under the relevant legislation, the Temporary Worker is not entitled to
receive payment from the Employment Business or Clients for time not spent on Assignment, whether in
respect of holidays, illness or absence for any other reason unless otherwise agreed.

4.3 The Employment Business shall pay the Temporary Worker remuneration regardless of whether the
Employment Business has secured or received payment from the Client.

5. STATUTORY LEAVE
5.1 For the purposes of calculating entitlement to paid annual leave pursuant to the Working Time Regulations
1998 under this clause, the leave year runs from 1st January to 31st December.

5.2 Under the Working Time Regulations 1998 (as amended), the Temporary Worker is entitled to at least the
statutory minimum entitlement of paid leave per year as it is from time to time. Annual leave must be taken
during the year in which it accrues, and none may be carried forward to the next year.

5.3 Entitlement to payment for leave accrues in proportion to the amount of time worked continuously by the
Temporary Worker on Assignment during the leave year.
*Payments for annual leave will be calculated on the basis of rates paid during a Client's normal working hours
i.e. those that do not attract overtime rates of pay.

5.4 In the course of any Assignment during the first leave year, the Temporary Worker is entitled to request leave
at a rate of one-twelfth of his total holiday entitlement in each month of his leave year. Where the Temporary
Worker wishes to take any leave to which he is entitled, he should notify the Employment Business in writing
of the dates of his intended absence. The amount of notice that the Temporary Worker is required to give
should be at least twice the length of period of leave that he wishes to take, unless the Employment Business
informs the Temporary Worker in writing that it is not possible for him to leave on the specified dates, the
Temporary Worker shall be entitled to take up his notified leave entitlement.

5.5 Where a Bank Holiday or other public holiday falls during an Assignment and the Temporary Worker does not
work on that day, the public holiday shall count as part of the Temporary Workers paid annual leave
entitlement.

5.6 None of the provisions of this clause regarding the statutory entitlement to paid leave shall affect the
Temporary Workers status as a self-employed worker.

6 SICKNESS AND ABSENCE

6.1 The Temporary Worker may be eligible for Statutory Sick Pay, if he meets the relevant statutory criteria.

6.2 For the purposes of the Statutory Sick Pay Scheme, there is one qualifying day per week during an Assignment
and that qualifying day shall be Wednesday in every week.

7 TIME SHEETS
7.1 At the end of each week of an Assignment (or at the end of the Assignment where it is for a period of one week
or less or is completed before the end of a week) the Temporary Worker shall deliver to the Employment
Business his time sheet duly completed to the number of hours worked by him during the preceding week (or
AJD/LKA/APPFORM 7
 such lesser period) and signed by an authorised representative of the Client. Failure to submit a time sheet for
hours worked may delay payment for those hours.

7.2 For the avoidance of doubt and for the purpose of the Working Time Regulations, the Temporary Worker's
working time shall only consist of those periods during which he is carrying out his activities or duties for the
Company as part of the Assignment. Time spent traveling to the Company's premises, lunch breaks and other rest
breaks shall not count as part of the Temporary Worker's time for these purposes.

8 CONDUCT OF ASSIGNMENTS
8.1 The Temporary Worker is not obliged to accept any Assignment offered by the Employment Business, but if he
does during every Assignment and afterwards, where appropriate, he will:

• Cooperate with the Client's staff and accept the direction, supervision and control of any responsible person
in the Client's organisation.
• Observe any relevant rules and requirements of the Client's establishment to which attention has been
drawn or which the Temporary Worker might reasonably be expected to ascertain.
• Unless arrangements have been made to the contrary, conform to the normal hours of work in force at the
Client's establishment.
• Take all reasonable steps to safeguard his own safety and the safety of any other person who may be present
or affected by his actions on the assignment and comply with the Health and Safety policies of the Client.
• Not engage in any conduct detrimental to the interest of the Client or the Employment Business.
• Nor at any time divulge to any person, nor use for his own or any other person's benefit, any confidential
information relating to the Client's or Employment Business employees' business affairs, transactions or
finance.

8.2 If the Temporary Worker is unable for any reason to attend work during an Assignment, he should inform the
Client and/or the Employment Business by no later than 10:00 am on the first day of absence to enable
alternative arrangements to be made.

8.3 Where a Temporary Worker is employed as a driver with a Client, the Temporary Worker is expected to
undertake his work exercising reasonable care and skill. In the event of an accident which results from the
Temporary Worker's negligence, the Temporary Worker will be liable for the company's losses arising from the
access up to a maximum of £200. The Employment Business has the right to deduct any such sums from the
driver's pay.

8.4 PCN – Drivers will be responsible for the cost of any fines incurred to LKA recruitment from the client or Penalty
Charge Notices received while driving for LKA Recruitment. including Daily insurance cost (failure to show up for
work and not informing LKA), The Employment Business has the right to deduct any such sums from the
Candidates pay.

8.5 CPC Training Course (if applicable) If an agreement is reached to attend the course, monies will be deducted from
wages in 2 instalments or you may pay in fully upfront

9 TERMINATION
The Employment Business or the Client may, without prior notice or liability, instruct the Temporary Worker to
end an Assignment at any time.

9.2 The Temporary Worker may terminate an Assignment at any time immediately by informing the Employment
Business. 10 THE LAW 10.1 These terms are governed by English Law and are subject to the jurisdiction of the
English Courts.

10 THE LAW
10.1 These terms are governed by English Law and are subject to the jurisdiction of the English Courts.

Signature       Date      

GDPR & Privacy Policy

The information that you provide on this form and on any CV given will be used by LKA recruitment to provide you
work finding services. In providing this service to you, you consent to personal data being included on a
computerized database and consent to use transferring your personal details to our clients. We may check the
AJD/LKA/APPFORM 8
information collected with third parties or with other information held by us. We may also use or pass to certain
parties’ information to prevent or detect crime, to protect public funds, or in other ways permitted or required by
law.

GDPR
The new General Data Protection Regulations (GDPR) came into effect in May 2018. This new law is designed to keep
you and your personal data safe so you will need to ‘opt-in’ in order to be kept on our lists so that you can:
Be Kept informed of new jobs
Receive relevant news and updates

If you still wish this to be the case, tick yes below. If you would like to be removed from LKA’s list , please tick ‘NO’
Yes No If you would like to received more information please tick this box

Candidate Document *Please read carefully before signing*

I hereby confirm that the information given is true and correct. I consent to my personal data and CV being
forwarded to clients. I consent to reference being passed onto potential employers.

I confirm that I would like to opt out of the 48 hour working week Yes No

If during a temporary assignment, the Client wishes to employ me direct, I acknowledge that LKA Recruitment will
be entitled to either charge the Client an introduction/transfer fee, or to agree an extension of the hiring period
with the Client (during which I may be employed by the Client without further charge being applicable to the
Client)

Medial
I also confirm that I am fit for work and have no medical problems that could affect my work.

CRB Check
To be considered for work with certain in clients we require authorization to conduct a criminal records check.

Personal Data Release Authority

I hereby consent to details concerning my past employment, education, or benefits, held under the GDPR to be released to
LKA Recruitment for the purpose of obtaining references or other evidence which may prove my employment history or status

Signed:      

Print Name:      

Date:      

For Office Use Only – Registration and Interview Assessment.

Name of Temp: Registered By: Date:

General Appearance:  Excellent  Good  Average  Poor

General Attitude:  Excellent  Good  Average  Poor

Any objections to early start time?  Yes  No

Any objections adhering to LKA
procedures?  Yes  No Earliest start:

Will they be prepared to be a standby  Yes  No Latest call:

AJD/LKA/APPFORM 9
 S/Boots  High Vis  Gloves  Hard Hat  Trousers  Goggles

How did you hear about LKA ?

Experience:

Availability:  ASAP  1 Week  2 Weeks  1 Month Other

London: Yes/No Suffolk Yes / No

Miles Prepared to Travel:  10 miles  20 miles  25 miles 30 miles  35 miles Other:

Shifts:  Mon-Fri Days  Nights  Weekends  Nights Out  Tramping Other:

DO NOT SEND TO:

Documents Seen:
 Passport  Visa  Proof of NI  Birth Certificate  D/Licence  HIAB Cert
 FLT RCH  Rhides  FLT C/B ADR Cert  Proof of Address

Convictions: Illnesses:

Holidays Booked: Other Dates:

Reviewing Medical Questionnaire Assessment: Can Work Nights: Yes/No Cannot Work Nights: Yes/No
Opt out 48 hour Yes/No
Signed by: Date
LKA Consultant Registered:

AJD/LKA/APPFORM 10