Payment Information

Payment Information

Please read each section and confirm where requested. Items marked * are required.

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Candidate Details

Full Name *

Email Address *

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Authority to Make Deductions from Wages

I authorise PB Recruitment Solutions Ltd to make deductions from sums due to me (including final pay) in respect of:
(i) annual holidays over-taken or overpayment of wages; (ii) loss of or damage to stock or property (including vehicles) arising through my fault or negligence; and
(iii) failure to return company-issued PPE in reusable condition on my final working day. I understand I will be notified in writing when a deduction is made.

I agree to the deductions described above.

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Important Information

Hard Hats / PPE: Wear where required (including when operating/around forklifts). You must inspect your PPE before and after use,
report defects, wear as instructed and store appropriately. Maintenance: store safely when not in use; visually inspect before use for damage/deterioration;
report defects so components can be replaced as soon as possible. Any loss of hard hats — replacements will be chargeable to you by the Company.

Seat Belts: Must be worn in company vehicles, forklifts and when required on company premises. Report immediately if you are unable to wear a seat belt.

Dust Masks: Follow Poultry Dust guidance. Where exposure could occur, request and use suitable masks and follow instructions provided.

I confirm I have read and understood the Important Information above.

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Acknowledgement of Contract for Services

I confirm I have received a copy of my Contract for Services, have read and retained the Workers’ Handbook, and have received PB Recruitment Solutions’ initial recruitment/selection briefing and been assessed in food safety and health & safety awareness.

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48-Hour Working Week Opt-Out

You may opt out of the 48-hour average weekly working limit. You can withdraw consent with 3 months’ written notice.

Your choice

Yes (opt out)No (keep 48-hour limit)
I understand I may withdraw this opt-out with 3 months’ written notice.

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Modern Slavery — Confidential Check

If you or someone you know may be at risk, you can contact: Police 999 (emergency) / 101 (non-emergency);
Gangmasters & Labour Abuse Authority (GLAA); UK Modern Slavery & Exploitation Helpline 08000 121 700.

Anything else you’d like to tell us (confidential)

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Equal Opportunities Monitoring (Optional)

This form is detached from your application and held separately from selection information.

Full Name (optional)

National Identity
EnglishBritishWelshScottishNorthern IrishOtherPrefer not to disclose

Ethnic Category
—Please choose an option—White — English/Welsh/Scottish/Northern Irish/BritishWhite — IrishWhite — Gypsy or Irish TravellerWhite — Any otherMixed — White and Black CaribbeanMixed — White and Black AfricanMixed — White and AsianMixed — Any otherAsian — IndianAsian — PakistaniAsian — BangladeshiAsian — ChineseAsian — Any otherBlack — AfricanBlack — CaribbeanBlack — Any otherOther ethnic group — ArabOther ethnic group — Any otherPrefer not to disclose

If Yes, do you require reasonable adjustments?

Prefer not to disclose Age/DOB

Religion or Belief
—Please choose an option—No Religion or beliefBuddhistChristianHinduJewishMuslimSikhAny other religionPrefer not to disclose

Sexual Orientation
—Please choose an option—Heterosexual/straightGay woman/lesbianGay manBisexualOtherPrefer not to disclose

Are you married or in a civil partnership?
YesNoPrefer not to disclose

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Final Declaration

I confirm the information given is true and correct. I consent to my personal data and CV being forwarded to potential employers/hirers,
and to references being requested and shared with potential employers/hirers. If, during an assignment, the client wishes to employ me direct,
I acknowledge PB Recruitment Solutions Ltd may charge an introduction fee or agree an extension of the hiring period.

Print Name *

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