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English
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Personal information
First name(s)
Initial(s)
Surname
Gender
-
Female
Male
Day of birth
Birthplace
Country of Birth
-
Andorra
Aruba
Austria
Belgium
Brazil
Bulgaria
Canada
Cyprus
Czech Republic
Denmark
Eritrea
Estonia
Finland
France
Germany
Ghana
Greece
Hungary
Indonesia
Iraq
Ireland
Italy
Kroatië
Latvia
Libya
Lithuania
Luxembourg
Maleisie
Malta
Moldavia
Morocco
Nigeria
Poland
Portugal
Romania
Slovakia
Slovenia
South Africa
Spain
Suriname
Sweden
Switzerland
Syria
Thailand
The Netherlands
Turkey
Ukraine
United Kingdom
Venezuela
Vietnam
Wit Rusland
Maiden name
Marital status
-
Cohabitant
Divorced
Married
Single
Widow/Widower
Sofi number/BSN number
-
No
Yes
Nationality
-
Afghan
Andorrese
Arubaanse
Austrian
Belgian
Brazilian
Bulgarian
Canadian
Cuban
Cyprus
Czech
Danish
Dutch
English
Eriterese
Estonian
Finnish
French
German
Ghanaian
Greek
Hungarian
Indonesian
Iraqi
Irish
Italian
Keniaanse
kroatische
Lachican
Latvian
Lebanese
Lithuanian
Luxembourgish
Maleisische
Moroccan
Polish
Portuguese
Romanian
Slovak
Slovenian
Somali
South African
Spanish
Surinamese
Swedish
Swiss
Syrian
Thai
Turkish
Ukrainian
Vietnamese
Wit-Russische
Yemeni
Available for work from
Available for work from
Registration adress
Street
house number
Zipcode
City
Country
-
Andorra
Aruba
Austria
Belgium
Brazil
Bulgaria
Canada
Cyprus
Czech Republic
Denmark
Eritrea
Estonia
Finland
France
Germany
Ghana
Greece
Hungary
Indonesia
Iraq
Ireland
Italy
Kroatië
Latvia
Libya
Lithuania
Luxembourg
Maleisie
Malta
Moldavia
Morocco
Nigeria
Poland
Portugal
Romania
Slovakia
Slovenia
South Africa
Spain
Suriname
Sweden
Switzerland
Syria
Thailand
The Netherlands
Turkey
Ukraine
United Kingdom
Venezuela
Vietnam
Wit Rusland
In possesion of a drivers licence
Valid until
Clothing size
-
Extra large
Extra Small
Large
Medium
Small
Lenght
-
155
165
175
185
195
205
Shoe size
-
35
36
37
38
39
40
41
42
43
44
45
46
Mobile Number
Emergency phone number
E-mailadres
Do you wish housing in the Netherlands through AUB:
-
No
yes
Do you wish a health insurance through our collective (compulsory in the Netherlands)
-
No
yes
If you answered the above question with ‘No’, then you have to provide AUB van Bergen with a health insurance card or policy of your own insurance.
Do we have to apply the tax-free allowance when we employ you?
-
No
yes
Please indicate below what kind of work interests you. The greater your interest, the greater job security we can offer you.
Are you interested in working in greenhouse horticulture?
-
Ja
Nee
Are you interested in working in recycling?
-
Ja
Nee
Are you interested in working in the meat industry?
-
Ja
Nee
Are you interested in working in repackaging?
-
Ja
Nee
Are you currently in the Netherlands?
-
Ja
Nee
Foreign languages
Dutch language
-
Good
Moderate
Not
Poor
German language
-
Good
Moderate
Not
Poor
English language
-
Good
Moderate
Not
Poor
Polish language
-
Good
Moderate
Not
Poor
Romanian Language
-
Good
Moderate
Not
Poor
Bulgarian language
-
Good
Moderate
Not
Poor
Do you have relevant work experience.
-
No
yes
Work experience
Until
Start
Name of the company
Phone number
Place
A short description of your tasks and responsibilities
Add
Was this through an employment agency ?
-
No
yes
Did you accrue pension there?
-
No
yes
Upload hier het bewijs van uw werkervaring. Bijvoorbeeld loonstrook, of overzicht. Indien u geen bewijs levert wordt uw werkervaring als niet geldig verklaard.
Upload hier uw cv
I hereby declare that, prior to this registration, I have resided in the Netherlands and that I was recruited in the Netherlands.
Education
Name education/class
Name of school
Place
Country
-
Andorra
Aruba
Austria
Belgium
Brazil
Bulgaria
Canada
Cyprus
Czech Republic
Denmark
Eritrea
Estonia
Finland
France
Germany
Ghana
Greece
Hungary
Indonesia
Iraq
Ireland
Italy
Kroatië
Latvia
Libya
Lithuania
Luxembourg
Maleisie
Malta
Moldavia
Morocco
Nigeria
Poland
Portugal
Romania
Slovakia
Slovenia
South Africa
Spain
Suriname
Sweden
Switzerland
Syria
Thailand
The Netherlands
Turkey
Ukraine
United Kingdom
Venezuela
Vietnam
Wit Rusland
Starting year
Until
Succesfully finished
Add
Allergies
Please complete the survey below so that we can prepare better for the reception of people with allergies. Please fill in the following truthfully:
Latex
-
No
yes
Tomatoes
-
No
yes
Pollen
-
No
yes
Nuts
-
No
yes
Onions
-
No
yes
How did you find us?
Enter how you found us. Choose one of the options.
-
Facebook
Family/Friends
Google
Leaflet/Poster
Newspaper
Niedziela.nl
OLX
Pracuj.pl
Radio
Website
Werver
Which recruiting office did you first have contact with (for example: Beyond Resources, F.A.S Packing, Wiatrak-Jobs, AUB)?
Statement by the jobseeker:
I certify that I have voluntairily given all data in the questionaire and that I understand that Van Bergen Personeelsdiensten B.V. needs this data to provide me of (temporary) work.
I consent to process my personal data by Van Bergen Personeelsdiensten B.V. estabilshed in Hoek van Holland, Prins Hendrikweg 16 3151AE, and/or For All Seasons Packing Sp. z o.o. with the headquaters in Olsztyn, Herberta 14/23, 10-686 Olsztyn and/or Beyond Resources Sp. z o.o. with the headquaters in Olsztyn, Herberta 14/23, 10-686 Olsztyn, when needed for processing the selection procedure:
I give permission to store my data for a period of 1 year for the purpose of this application.
I have the right to give written instructions by mail to stop the recruitment process and ask to destroy my personal information
I ceritify that the information I have given is thruthfully
I grant permission to make my personal information available when needed for a (temporary) employment
When it appears during the selection that we won`t use your application your personal data will be destroyed
I accept the above conditions