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registration form

Submit your registration details here to start your search for a new career with Fill Recruitment. Please try to complete this before your meeting with one of our consultants, although it is possible for this to be done on the day of your registration.

All fields marked with an asterix are mandatory

Personal Details
Name	Title:
	Surname*
	Forename(s)*
Home details	Building
	Street
	District
	City
	County
	Country
	Postcode
Contact details	Home Telephone
	Mobile Telephone*
	Email Address*
Personal details	Date of Birth [dd/mm/yyyy]:
	NI Number
	Marital Status:
	Nationality:
	Have you any unspent convictions? (If yes, please provide details):
	Convictions details
	Please answer the following if you are NOT a citizen of the European Economic area, (Eg: Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and UK)
	Are you eligible to work in the UK? If yes, what type of visa do you hold?:
	Visa type:
	When does this visa expire?
	Have you got a valid and current driver's licence?:
	Upload a Personal Photo (jpg,gif,png up to 200Kb)	Please upload a recent picture to add to your record, if you don't have one available, no problem, we can take one on the day of your registration (these are for our records only and will not be passed onto clients)
Employment Details
Current Employment	Company Name
	Number of years in current employment
	Current / Preferred Job Title*
	Current Salary
	Notice Period:*
	Reason for considering leaving
Future Employment	Required Annual Salary
	Required Day Rate (Freelance ONLY)
	Type of work wanted:*
	Position Required (please delete as applicable)
	Sales Promotion:
	Integrated:
	Digital:
	Direct Marketing:
	Other (Please Specify)
	Preferred Geographical Location(s)
	Agencies you would like to work at
References
REFERENCES: Please note here the name, address and contact details of two persons from whom we may obtain work experience references. If you wish, you can provide references details at a later date.
Reference 1	Name of Referee
	Relationship to You
	Contact Address
	Contact Number(s)/ Email Address
Reference 2	Name of Referee
	Relationship to You
	Contact Address
	Contact Number(s)/ Email Address
Source	How did you hear about Fill Recruitment?*
Declaration
* I confirm that the information I have given is correct and that should it be required, I will provide evidence of identity and eligibility to work in the UK and any/all original certificates of qualifications gained. I hereby give my consent that Fill Recruitment Ltd (Employment Agency) represent me in finding permanent employment. I understand that Fill Recruitment Ltd adhere to the Data Protection Act 1998 and my personal data will be held on Fill Recruitment's database and will be made available to clients for the purpose of CV searches.
For our own research purposes, please can you advise us of three websites that you have found useful in your job search		1. 2. 3.

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