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Written Statement of Particulars of Employment

Please complete by selecting any of the following which apply to you now or in the past which could impact your ability to carry out the role with Glen Group.


The reason for requesting this information is due to the physical nature of the role; for health and safety reasons and risk assessment purposes and to comply with any insurance requirements. The information will be retained in a confidential manner in your employee file:

Heart problems: angina, blood pressure, heart attack
Yes
No
Epilepsy or fainting attacks
Yes
No
Diabetes
Yes
No
Epilepsy or fainting attacks
Yes
No
Skin allergies: dermatitis, eczema
Yes
No
Back pain or injury such as slipping disc, arthritis, rheumatism, neck pain
Yes
No
Have you ever worked in high noise level areas in the past
Yes
No
Is there a medical reason that prevents you from working night-time? (Applicable for night shift workers)
Yes
No

Please read the following document and sign below. This document outlines your main Terms and Conditions of Employment with Glen Group, 2 Britannia Buildings, Merchants Road, Bristol BS8 4QD and is defined by The Employments Rights Act 1996, as amended by the Employment Act 2002 these should be read in conjunction with the Employee Handbook.


1. Personal Information: Your name, address, telephone number, emergency contact details and other information supplied by you will be held by Glen and it is your responsibility to update your manager should these details change. If your bank account details change, Payroll should be notified immediately to ensure your salary is paid into the correct account. You are required to provide an email address as correspondence referred to and other communications from the company will be provided by email.


I have read and understood the content of this document and all other documents referred.

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