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Registration
Registration Form
The Immigration Act 2014 requires Safer Roadworks Group of companies to check documents to establish a person's eligibility to work in the UK and comply with any restrictions. Under the legislation, we are required to check documents before you start work. Please view our
Right to Work Checking Policy
and
Privacy Policy
.
What area of Safer Roadworks vacancies would you like to apply for?
Traffic Management
Civils & Utilities
PERSONAL DETAILS
Title
First Name
Last Name
Your Address
House Name/Number
Street Address
Street Address Line 2
City
County
Post Code
Date of Birth
National Insurance Number
Phone Number
Email Address
Are you eligible to work in the UK?
Yes
No
What reason gives you eligibility to work in the UK
British Citizen
European Economic Area National
Residence/Work Permit
Do you have a full UK Driving licence?
Yes
No
Upload Drivers licence, front and back
Please enter a DVLA Licence Check Share Code below
Proof of National insurance number FROM HMRC not a wage slip
Picture of Passport corner to corner or Birth Certificate
Previous
Next
NEXT OF KIN
First Name
Last Name
Phone Number
Relationship to you
Next of Kin Address
House Name/Number
Street Address
Street Address Line 2
City
County
Post Code
Previous
Next
EMPLOYMENT DETAILS
Are you currently employed?
Yes
No
What Companies have you worked for, either employed or self-employed/agency (optional)
Would you be able to pass a drug and alcohol test upon request, at any time?
Yes
No
Would you be prepared to work away from home
Yes
No
Do you have any grievance with any companies?
Yes
No
Please provide companies where you cannot work
Previous
Next
SKILLS & QUALIFICATIONS
Please let us know what qualifications you hold
Please entre your Lantra card number, if applicable:
Highways England Common Induction
Yes
No
If yes, please attach a picture of your card
Safety Critical Medical
Yes
No
If yes, please attach a picture of your certificate
CITB Site Safety Plus / SSTB / SMSTS
Yes
No
If yes, please attach a picture of your certificate
Any other supporting information:
Please use the box above to tell us anything else that we've missed or need to know
Previous
Next
Payment Details
We ask for your payment information to speed up our registration process and to ensure you are paid for any work carried out promptly and efficiently. If you would prefer not fill in your bank details through the online form, please check the box below and skip straight through to the next section. Our accounts team will call you to collect your information over the phone.
Call me to collect my payment information
Yes
Bank Name
Name of Account Holder
Sort Code
Account Number
Previous
Next
Declaration - You're nearly there!
Please check the following statement:
I have read, understand and agree to adhere to all Safer Roadwork's company policies.
Please check the following statement:
I agree for you to complete a drivers licence check using the details provided (if applicable)
Signature
Date
The Immigration Act 2014 requires Safer Roadworks Group of companies to check documents to establish a person's eligibility to work in the UK and comply with any restrictions. Under the legislation, we are required to check documents before you start work. Please view our
Right to Work Checking Policy
and
Privacy Policy
.
What area of Safer Roadworks vacancies would you like to apply for?
Traffic Management
Civils & Utilities
PERSONAL DETAILS
Title
First Name
Last Name
Your Address
House Name/Number
Street Address
Street Address Line 2
City
County
Post Code
Date of Birth
National Insurance Number
Phone Number
Email Address
Are you eligible to work in the UK?
Yes
No
What reason gives you eligibility to work in the UK
British Citizen
European Economic Area National
Residence/Work Permit
Do you have a full UK Driving licence?
Yes
No
Upload Drivers licence, front and back
Please enter a DVLA Licence Check Share Code below
Proof of National insurance number FROM HMRC not a wage slip
Picture of Passport corner to corner or Birth Certificate
NEXT OF KIN
First Name
Last Name
Phone Number
Relationship to you
Next of Kin Address
House Name/Number
Street Address
Street Address Line 2
City
County
Post Code
EMPLOYMENT DETAILS
Are you currently employed?
Yes
No
What Companies have you worked for, either employed or self-employed/agency (optional)
Would you be able to pass a drug and alcohol test upon request, at any time?
Yes
No
Would you be prepared to work away from home
Yes
No
Do you have any grievance with any companies?
Yes
No
Please provide companies where you cannot work
SKILLS & QUALIFICATIONS
Please let us know what qualifications you hold
Please entre your Lantra card number, if applicable:
Highways England Common Induction
Yes
No
If yes, please attach a picture of your card
Safety Critical Medical
Yes
No
If yes, please attach a picture of your certificate
CITB Site Safety Plus / SSTB / SMSTS
Yes
No
If yes, please attach a picture of your certificate
Any other supporting information:
Please use the box above to tell us anything else that we've missed or need to know
Payment Details
We ask for your payment information to speed up our registration process and to ensure you are paid for any work carried out promptly and efficiently. If you would prefer not fill in your bank details through the online form, please check the box below and skip straight through to the next section. Our accounts team will call you to collect your information over the phone.
Call me to collect my payment information
Yes
Bank Name
Name of Account Holder
Sort Code
Account Number
Declaration - You're nearly there!
Please check the following statement:
I have read, understand and agree to adhere to all Safer Roadwork's company policies.
Please check the following statement:
I agree for you to complete a drivers licence check using the details provided (if applicable)
Signature
Date
