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Hello, we're looking forward to helping you find your next role!

Please complete the form below and click the Submit button at the bottom. Fields with a red border are required.
Need help?
Call 01206 548421
You can also call into in our Colchester office


Date Of Birth

National Insurance Number

If you are looking for temporary work and we find you a suitable position, we will require your bank details so we can pay you. However if you feel uncomfortable giving this information at this stage, please feel free to bypass these fields.

Bank Account Number

Bank Account Sort Code

Does any one else have access to your bank account, card and pin number? Yes No

If yes, please explain who has access and why below...

If you are a non UK citizen, we will require proof of right to work. For more information, click here: https://www.gov.uk/view-right-to-work. Please enter your right to work share code below.

Do you have a full, valid UK driving licence? Yes No

Do you have access to your own vehicle? Yes No

Do you have business insurance? Yes No

Do you require a visa to work in the UK? Yes No

If yes, what type of visa do you have?

Are you restricted to how many days you can work? Yes No

If yes, how many days a week are you allowed to work?


Please upload as many of the documents requested below as you can. Click here to view a guide outlining the documents we may need from you and why.


If you do not not have a C.V. to upload, please complete the following fields.

Coronavirus (COVID-19)

With the recent outbreak of Coronavirus (COVID-19) the safety and wellbeing of our candidates and customers is priority, please click here to read a PDF before continuing.

Have you tested positive for Coronavirus (COVID-19) in the last 10 days? Yes No

If so, on what date did your symptoms begin?

Have you received any Coronavirus (COVID-19) vaccinations? Yes No

If so, please complete dates of vaccines below...

Contact Details

Current Address

When did you start living at this address?


Emergency Contact

In case of emergency, who should we contact?

Education / Employment

Are you a student? Yes No

If yes, please tell us where you are studying?

Are you currently employed? Yes No

If not, please explain why?

Current / Last Employer

Please enter the date started below.

Please enter the date finished below. If this is your current employer, enter todays date.

Your employment history must cover the last 5 years to proceed with your registration.

If your current / last employer does not cover the last 5 years, please complete the previous employer fields below covering the last 5 years (and indicate two positions which can be used as a reference). If this does not apply, please click here to continue.

Previous Employer 1

Ok to contact for reference? Yes No

If yes, please enter reference contact details below.

Previous Employer 2

Ok to contact for reference? Yes No

If yes, please enter reference contact details below.

Previous Employer 3

Ok to contact for reference? Yes No

If yes, please enter reference contact details below.

Previous Employer 4

Ok to contact for reference? Yes No

If yes, please enter reference contact details below.

If your employment history does not cover the last 5 years, please explain why below..

Have you worked for an agency before? Yes No

Courses & Qualifications

Please check all that apply to you.

Residential support worker

Level 2 Diploma in Work Preparation for Health and Social Care
Level 2 GCSE in Health and Social Care
Level 2 Certificate or Level 3 Diploma for the Children and Young People’s Workforce
Level 2 Certificate or Level 3 Diploma in Youth Work Practice

Healthcare assistant

Level 2 Certificate in Work Preparation for Health and Social Care
Level 2 Diploma in Health and Social Care
Level 3 National Extended Diploma in Health and Social Care

Senior care worker

Level 3 Diploma in Health and Social Care
Level 4 Diploma in Health and Social Care Management

Other qualifications

Activities & Exercise
Alcohol Misuse
Assessing Needs
Autism Awareness
Bipolar Disorder
Bloodborne Pathogens
Care Planning
Challenging Behaviour
Cognitive Behavioural Therapy
Communicating Effectively
Continence Promotion
Dementia Care
Deprivation of Liberty Safeguards
Develop as a Worker
Disaster Planning
Diversity and Equality
Drug Misuse
Dying, Death and Bereavement
Eating Disorders
Fire Training
First Aid Awareness
Food Hygiene
Hand Hygiene Training
Health and Safety
Induction Awareness
Infection Control
Latex Allergy
Mental Capacity
Moving and Handling Assessment
Moving and Handling Theory
Needlestick Injury
Nutrition and Diet
Obsessive Compulsive Disorder
Pain Management
Panic Attacks
Person Centred Care
Personality Disorders
Post Traumatic Stress Disorder
Pressure Care
Principles of Care and Confidentiality
Record Keeping
Risk Assessment
Role of the Care Worker
Safe Administration of Medicines
Safeguarding of Vulnerable Adults
Safeguarding of Vulnerable Young People
Skin Care
Stress Management
Supervision and Appraisal
Team Teach Restraint & De-escalation Training
Train the Trainer
Understand Your Organisation
Wound Care


Do you have a valid DBS? Yes No

Is your DBS on the update service? Yes No

Does your DBS cover Young People Adults Young People & Adults

Job Details

If permanent or either, please select an expected salary range

Or if temporary, please enter your expected hourly rate

More Information

Have you any convictions which are not yet spent under the terms of the Rehabilitation of Offenders Act 1974 (exceptions)Order 1975 (as amended in 2013) (ROA)? Yes No

If yes, please provide details below or submit a written declaration or disclosure directly to info@topjobrecruitment.com. Some job roles may require further checks and be exempt from the ROA where you may need to disclose spent convictions, cautions warnings etc - you will be advised of this if this is required. Failure to disclose all unspent convictions may result in the termination of any assignment or the withdrawing of TOP JOB RECRUITMENT services. The information provided in this section Convictions is a special category of data and as such is processed subject to our Data Protection Policy

Do you have any health issues which may affect your employment? Yes No

If yes, please provide details below

Are there any medical reasons, or are you currently taking any medication, that will affect your ability to work nights? Yes No

If yes, please provide details below

If you have a disability covered by DDA, what are your needs etc.

Where did you hear about Top Job Recruitment?


I hereby confirm that the information given is true and correct. If during the course of a temporary assignment the Client wishes to employ me directly, I acknowledge that Top Job Recruitment will be entitled to either charge the Client an introduction/transfer fee, or to agree an extension of hiring period with the Client (during which time I may be employed by the Client) without additional charges being applicable to the Client.

Yes No

Our Policies

Please click to read the following policy documents

48 Hour working week agreement opt out terms and conditions

Privacy Notice

Data Protection Policy

Data Retention Policy

Have you read the policy documents and do you agree with them? Yes No

You must check Yes above to proceed with your registration.


Finally, please complete our registration feedback form below.

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You must check the check box above to proceed. If you do not, your registration will be deleted and you'll have to complete this form again.

Let’s work together.

Call us 01206 548421

We’re open Mon–Fri, 8.30am – 5.00pm

Howdy, partners

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