Registration Form

To be able to complete this form, you will need to be able to provide: a proof of ID, a proof of address and copies of CSCS / CPCS. A form at the bottom will allow you to attach these as image format.

Personal Information

Title *

First Name *

Last Name *

Address *

Date of Birth *

Email Address *


Home Phone

Mobile Phone


Passport Number

National Insurance Number

Looking for?

Preferred Job Role

Preferred Pay Rate


Visa Information (if applicable)

Do you require a work visa or work permit to work in the UK? Please give details here

Work Visa or Work Permit (if applicable)

Work Visa or Work Permit

Work Visa or Work Permit

CSCS Card Information (if applicable)


CSCS Number

CSCS Expiry

CPCS Card Information (if applicable)


CPCS Number

CPCS Expiry


Valid Driving Licence

Access to car

Reference 1






If via agency please state which

Reference 2






If via agency please state which

Next of Kin




Home Phone

Mobile Phone

Criminal Record Disclosures

Do you have any unspent convictions?

Is there any other information you should disclose that a potential employer should know or might need to make adjustments to your working environment.

Do you have any medical conditions that might impact on your ability to work or might need consideration in making a placement for you?

(If you have answered yes to this question we will send a medical questionnaire)

Banking Details

Please indicate your preferred method of payment and some details about your banking arrangements. These will be confidentially held and only entered onto our system to make payments following a successful placement. This information is not essential to completing a registration but may speed up payments following placement.

Please indicate whether you would like to be paid as:


Umbrella Company: Specify If you have a preferred company, or we can recommend one (please state 'Recommend')

Limited Company UTR: Please also upload your certificate of incorporation (Document upload at the bottom of the form)

Personal UTR Number: There are strict rules issued by HMRC on who can be paid this way. Check your status first.

Cheques payable to (unless otherwise directed we will pay you via BACS direct into your bank account)

Account Number

Account Name

Sort Code

Document Upload

Please upload documents for your: PROOF OF ID and PROOF OF ADDRESS and COPIES OF CSCS/CPCS

Too add more than one document, press 'Add new". To remove a document press "Remove"

Terms of Engagement of Temporary Workers

Contracts, Terms of Business and Policies are available on our website

├ó┬Ç┬£Assignment├ó┬Ç┬Ø Means the period during which the Temporary Worker is supplier to render services to the Client;

"Client" Means the person firm or corporate body together with any subsidiary or associated company as defined by the Companies Act 1985 requiring the services of the Temporary Worker;

"Employment Business" Means Clearfield Ltd

├ó┬Ç┬£Temporary Worker├ó┬Ç┬Ø Means: (your name)

1.2 Unless the context otherwise requires, references to the singular include the plural and references to the masculine include the feminine and vice versa.

1.3 The headings contained in these Terms are for convenience only and do not affect their interpretation.


2.1 These terms constitute a contract for services between the Employment Business and the Temporary Worker and they govern all Assignments undertaken by the Temporary Worker. However, no contract shall exist between the Employment Business and the Temporary Worker between Assignments.

2.2 For the avoidance of doubt, these Terms shall not give rise to a contract of employment between the Employment Business and the Temporary Worker. The Temporary Worker is engaged as a self-employed worker, although the Employment Business is required to make statutory deductions from their remuneration in accordance with clause 4.1.

2.3 No variation or alteration of these Terms shall be valid unless approved by the Employment Business in writing.


3.1 The Employment Business will endeavour to obtain suitable Assignments for the Temporary Worker to work as a

3.2 The Temporary Worker acknowledges that the nature of the temporary work means that there may be periods when no suitable work is available and agrees that suitability shall be determined solely the Employment Business; and that the Employment Business shall incur no liability to the Temporary Worker should it fail to offer opportunities to work in the above category or in any other category.

3.3 For the purpose of calculating the average number of weekly hours worked by the Temporary Worker on an Assignment, the start date for the relevant averaging period under the Working Times Regulation shall be 1st October 1998 or the date on which the Temporary Worker commences the first Assignment, if later.


4.1 The Employment Business shall pay to the Temporary Worker remuneration calculated at a minimum hourly rate of the actual rate will be notified on a per Assignment basis, for each hour worked during an Assignment (to the nearest quarter hour) to be paid weekly in arrears, subject to reductions in respect of PAYE Class 1 National Insurance Contributions and Income Tax pursuant to S134 of the Income and Corporation Taxes Act 1988 and any other deductions which the Employment Business may be required by law to make.

4.2 Subject to any statutory entitlement under the relevant legislation, The Temporary Worker is not entitled to receive payment from the Employment Business or Clients for time not spent on Assignment , whether in respect of rest breaks, holidays, illness or absence for any other reason unless otherwise agreed.

4.3 We undertake to pay the Temporary Worker regardless of whether we receive payment from our client.

4.4 The rate of pay will be above the current minimum wage and in line with the current market rate for the work undertaken.


6.1 At the end of each week of an Assignment (or at the end of the Assignment where it is for a period of one week or less or is completed before the end of a week) the Temporary Worker shall deliver to the Employment Business their time sheet duly completed to indicate the number of hours worked by them during the preceding week (or such lesser period) and signed by an authorised representative of the Client. Failure to submit a time sheet for hours worked will delay payment for those hours.

6.2 For the avoidance of doubt and for the purposes of the Working Time Regulations, the Temporary Worker’s working time shall only consist of those periods during which they are carrying out their activities or duties for the Client as part of the Temporary Worker’s working time for these purposes.


7.1 The Temporary Worker is not obliged to accept any Assignment offered by the Employment Business but if they do so, during every Assignment and afterwards where appropriate, they will:-

a) Co-operate with the Client’s staff and accept the direction, supervision and control of any responsible person in the Client’s organisation.

b) Observe any relevant rules and regulations of the Client’s establishment to which attention has been drawn or which the Temporary Worker might reasonably be expected to ascertain

c) Unless arrangements have been made to the contrary, conform to the normal hours of work in force at the Client’s establishment.

d) Take all reasonable steps to safeguard their own safety and the safety of any other person who may be present or affected by their actions on the Assignment and comply with the health and Safety policy of the Client.

e) Not engage in any conduct detrimental to the interest of the Client.

f) Not at any time divulge to any person, nor use for their or any other person’s benefit, any confidential information relating to the Client’s or the Employment Business’ employees, business affairs, transactions or finances.

7.2 If the Temporary Worker is unable for any reason to attend work during the course of an Assignment they should inform the Employment Business within one hour of the commencement of the Assignment or shift.


8.1 The Employment Business or the Client may, without prior notice or liability, terminate the Temporary Worker’s Assignment at any time.

8.2 The Temporary Worker may terminate an Assignment at any time without prior notice or liability

8.3 If the Temporary Worker does not inform the Employment Business in accordance with clause 7.2 should they be unable to attend work during the course of an Assignment, this will be treated as termination of the Assignment by the Temporary Worker in accordance with clause 8.2 unless the Temporary Worker can show that exceptional circumstances prevented them from complying with clause 7.2.

8.4 If the Temporary Worker is absent during the course of a Assignment and the contract has not been otherwise terminated, the Employment Business will be entitled to terminate the contract in accordance with clause 8.1 if the work to which the absent worker was assigned is no longer available to the Temporary Worker.

8.5 If the Temporary Worker does not report to the Employment Business to notify their availability for work for a period of three weeks, the Employment Business will forward their P45 to their last known address.


9.1 These terms are governed by the law of England and Wales and are subject to the exclusive jurisdiction of the courts of England and Wales.

Please confirm that the information you have given is true and accurate and you have made no omissions that might effect any potential placement. You are also confirming that you accept the terms and conditions that follow on the next two pages of this application form. In addition you are allowing Clearfield permission to hold your details on file and to share this information with a potential hirer, governing body or appointed auditor.