I give The Locum Agency permission to forward my CV to agreed Clients for the purpose of obtaining employment.

I hereby confirm that the information provided on my application is correct and true to the best of my knowledge and that I have not withheld any information that should be taken into account when offering me work.

I understand that providing false or inaccurate information may result in the termination of any placement.

I agree that I will make best endeavours to make myself aware of the Health & Safety procedures for each client I am assigned to.

I declare that by signing this form I am stating that I am legally entitled or allowed to work in the United Kingdom, with or without necessary permission from the Home Office or any other relevant authority. If I have secured permission to work, I have included copies of all documentation. I also acknowledge that if it is found that I am working without the relevant permission, my employment will be terminated with immediate effect and all details passed to the relevant authorities.

I agree that The Locum Agency retains the right to hold this registration form and any other data required to process it and pass onto any authorised third party and the details held within. I also agree to use all reasonable efforts to assist in order to comply with the Data Protection Act 1998.

I confirm that I have read and understood the Terms of Engagement and the terms of the declaration and agree to be bound by them.

I confirm that The Locum Agency have my permission to forward my CV and personal data (for e.g. occupational health details, DBS check) for vacancies that satisfy my requirements as stated above.

I hereby declare that at no time will I divulge to any person, nor use for my own or any other person’s benefit, any confidential information in relation to the Client or the Company (The Locum Agency) or in relation to any of their employees, business affairs, transactions or finances which I may acquire during the term of my agreement with the Company (The Locum Agency) under the Terms of Engagement.

Each agency worker has a responsibility at the start of their first shift to become familiar with the Client’s general policies including, without limitation, those relating to Crash Call Procedures, the Hot Spot Mechanism for alerting security staff that an individual is in trouble, Fire Policy and the Violent Episode Policy.

For the purposes of the Working Time Regulations 1998 (as amended) I consent to work in excess of an average of 48 hours per week, averaged over 17 weeks. I understand that I may withdraw this consent by giving The Locum Agency not less than three months’ notice at any time.
In addition, I also consent to work in excess of the maximum number of hours permitted to work at night under the directive. Please note you are under no obligation to sign either declaration.

By signing above I confirm to all the above statements within this document.

I confirm I have received, read and understood, and agree to abide by the contents of the The Locum Agency Locums Handbook.

I confirm I have received, read and understood the terms and conditions of engagement of The Locum Agency.

I can confirm I understand that my ID Badge must be visible at all times during a The Locum Agency Recruitment assignment and that if I leave The Locum Agency that I must Hand back my identity badge.

I confirm my personal data can be made available to any 3rd party without direct supervision from a member of staff from The Locum Agency or myself being present.