Europa Corby

Form 3 of 3

Next Step (Form 3)
Assignment Details Form
Details of the Employee
Forename(s)*
Surname*
Address
Street Address Line 2 City / Town County Postcode Country
Details of the Hirer
Name of the Hirer*
Nature of the Hirer’s business*
Name of Hirer’s contact to report to on arrival*
Report to on-site manager and you will be introduced to the appropriate client manager
Assignment Details
Likely duration of the Assignment*
Calendar weeks already accrued towards the Qualifying Period for the purposes of Regulations 7 and 8 of the Agency Workers Regulations 2010*
The type of work*
Location of work*
Hours of work*
05:45-13:45 / 08:00-16:00 / 07:30-18:00 / 14:00-22:00 / 18:00-04:30
The experience, training, qualifications and any authorisation necessary or required by law or a professional body*
Any known health and safety risks and the steps the hirer has taken to reduce the risks*
Collective Facilities
Hirer’s collective facilities available*
On site canteen, toilets
Pay
Actual Rates of Pay*
AM shift £10.59, AM shift Automation £11.79 PM shift £11.12 Nights Automation £13.58 per hour
Any expenses payable (if applicable)*
Intervals of Payment*
Annual Leave
Number of additional [paid/unpaid] annual leave days payable on completion of QP*
Contacts

Your Recruitment Consultant contact details:
Your recruitment consultant contact details*
Adela Pinczes - 07973960427
Signature*
Forename(s)*
Surname*
Date*
DD slash MM slash YYYY
Hidden
Sharepoint Email
Hidden
Branch Number
Hidden
Client/Site Name

Need assistance?
Call 0116 233 4404

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Europa Corby

Assignment Details Form

Details of the Employee

Details of the Hirer

Assignment Details

Collective Facilities

Pay

Annual Leave

Contacts

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