Registration Form

Personal data

Name

Name initials

Extra name

Surname

Sex

E-mail adress

Phone number

Place of birth

Country of birth

Nationality

Date of birth

BSN

Marital status

Account number (IBAN)

BIC / SWIFT

Type of identity document

ID number

The expiry date of the document

In possession of a driving license

Own transport

Address in the Netherlands

Street

House number

Number evt.letter

Postcode

place

Country

Address abroad

Street

House number

Number evt.letter

Postcode

place

Country

Experience

Experience 1

Client (name of the company)

Period of employment

Position

Experience 2

Bedrijfsnaam

Van

Functie

Experience 3

Bedrijfsnaam

Van

Functie

Language

English

Dutch

Certificates

EHS certificate

Forklift (front)

Reachtruck

Should FlexWorx! apply preferential charging of income tax (loonheffingskorting)?

Have you worked for another temporary work agency in the last six months? If yes, did you have the right to pension contributions there?

Date start - Date end / The name of the recruiting agency

Are there medical contraindications regarding your activities?

Do you have a medical certificate for performing any risky functions?

Would you like to take advantage of the option of opening a compulsory health insurance policy?

Are you known to the STIPP pension fund?

since when?

I hereby give FlexWorx! Uitzendbureau B.V. permission to store and process my personal data necessary to conclude an employment contract, also for future recruitment purposes"

“I have answered the questions truthfully”. “If it turns out afterwards that the questions were answered incorrectly, this has direct consequences for the offering of positions or an already concluded temporary employment contract. This will lead to deregistration or the cancellation of the agreement. ”