CASUAL WORKERS REGISTRATION FORM

PRIVATE AND CONFIDENTIAL

1. This form must be completed in full.

2. Application must be 16 years of age or over.
3. The Company is legally obliged to deduct tax and insurance and account to the authorities for such
deductions.
4. P45’s will not be issued for any period of engagement with Sodexho.

CASUAL WORKERS TO COMPLETE

Surname Actual Job Title

Initials
Forenames Number of Days Worked in Week? 5
Title Actual Days Worked
Sex M M T W T F S S
F
Date of Birth Hours Worked in Week
Address Bank Account Number
Bank Sort Code
Building Society Roll Number
Postcode Bank / Building Society Name
Home Telephone Number Bank / Building Society Address
Mobile Telephone Number
Have you ever been convicted of a crime or
offence that you need to declare?
Yes No
If yes Please Give Details Post Code

Emergency Contact Name, Address and

Telephone Number:
Francisco Ramirez

Medical Details
Have you suffered or do you suffer from any medical condition which would need to be considered when
working in our food preparation environment (e.g. salmonella)

Yes No

If Yes Please Give Brief Details:

TAX STATUS

Student? (if yes a P38 must be completed and sent to Payroll. Yes
No
Previously engaged by Sodexo Yes No
Details
 CASUAL WORKERS REGISTRATION FORM
PRIVATE AND CONFIDENTIAL

Equal Opportunities
We are an equal opportunities employer and the questions in this section are designed to ensure that we do not
discriminate against any applicant and our policy of equal opportunities is implemented

For Monitoring Purposes Only

White Black Caribbean Pakistani Other

Irish Black other Bangladeshi
Black African Indian Chinese

Driving Licence? Yes No

Do you have a disability within the meaning of the Disability Discrimination Act 1995 (this means physical or
mental impairment which has lasted or expected to last at least twelve months and which substantially effects
your ability to carry out normal day to day activities)?
Yes No

If YES, it would be helpful if you would list any practical steps which would put your application on an equal
footing with other candidates in the recruitment process, including the interview and any selection tests

Employment details
List all employers from present to first in that order. Previous employers will not be approached without the
applicant’s permission. If you have not been employed before please give names and address of 2 personal
referees below. Continue on a separate sheet if required.

Dates Name and Address of Brief Details of Duties with Position

Wage Reason For Leaving
From To Employer Held

Educational Details
Secondary Education details to be completed by persons aged 25 and below. Trade/Professional education
details to be completed by all those whom applicable
Dates Examination subjects taken with test results
Full name and address of Responsibilities held,
(give dates examined with grades obtained, i.e.
From To school or college societies etc
pass or fail)
 CASUAL WORKERS REGISTRATION FORM
PRIVATE AND CONFIDENTIAL

I certify that the information given on this form is true in every respect. I understand that if I am offered
a position by the company my engagement will be subject to satisfactory references and to my
passing a medical examination if required.

NO PAYMENT WILL BE MADE UNLESS THIS FORM IS DULY SIGNED BELOW

I confirm that the above details are correct

Employee Signature Date

Authorised Signature Date