Reliant Recruitment, permanent and temporary jobs in West Midlands, UK

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Transport Owned: " & c("fltlicence") bod = bod & "
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Shoe Size? " & c("shoe") bod = bod & "
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Additional Comments:" bod = bod & c("comments") & "

" rez=cdonts ("info@reliant.org.uk","register@reliant.org.uk",c("fullname") & " has submitted a Registration Form - " & c("email"),bod & ftr) %> <% End If %> Reliant Recruitment, permanent and temporary jobs in West Midlands, UK :: Register your Interest

home > register

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" method="post" name="frm" onSubmit="return checker()">

*Full Name:

Your email address:

Date of Birth:

*Home Phone Number:

*Address:

Mobile Phone Number:

*Post Code:

Nationality:

Marital Status:

National Insurance Number:

Next of Kin:

Next of Kin Phone Number:

*Please indicate roughly what job you are looking for.

Do you have a driving licence?

Do you have your own transport?

If yes please specify:

Do you have a FLT licence?

Do you have safety footwear?

Shoe size

Do you smoke?

Have you any convictions other than those which are spent?

If yes please give details:
(N.B. It is an offence to provide us with false information and will automatically stop any placement made if information is found to be withheld.)

Please give details of 2 referees who may be contacted:

Referee 1

Referee 2

Name:

Phone Number:

Relationship:

Previous Employment History

Position 1

Position 2

Starting Date:

Leaving Date:

Company Name :

Company Address:

Company Address :

Job Title:

Duties:

Supervisors Name:

Reason For Leaving:

Previous Skills / Experience.

Clerical Work:
General Labouring:
Packing:
Warehouse Work:
Warehouse Cleaning:
Sorter:
Stocktaking:
Order Picking:
Factory Assembler:
Food Handling:
PCB Assembler:
Furniture Handling:
LGV Class 1 Licence
LGV 7.5 ton Licence

Drivers Mate:
Trade Persons Mate:
Security Guard:
Electrical Hand Truck:
Fork Lift (electric):
Fork Lift (diesel):
Fork Lift (LPG)
Fork Lift (reach):
Fork Lift with clamps:
Fork Lift Counterbalanced:
Fork Lift Narrow Aisle:
Fork Lift Rough Terrain:
LGV Class 2 Licence
LGV Van Licence

Qualifications:

Additional Comments:

Welding:
General Labouring:
Fabrication:
Steel Erecting:
Gas Fitting:
Electrician:
Joinery:
Plastering:
Roofing:
Scaffolding:
Bricklayer:
Ground Work:
Pipe Fitter:

I understand that I am transmitting personal information over an insecure internet connection and agree to take total personal responsibility in the event of any third party intervention.

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Thank you for registering your details with Reliant.

Your details have been sent to us and will be processed shortly.
If you have any queries in the mean time please do not hesitate to contact our team.

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Alternatively you can send us a copy of your CV with a covering letter to:

Reliant
95 New Road
Willenhall
West Midlands
WV13 2BG

Click here to email your CV to us

Please note: Filling out the entire form is optional, We only require the fields in the top section of the form to be filled out (*)and we can contact you with futher details.