JOB APPLICATION FORM
Please fill out the form legibly in PRINT
1.
Given names:
2.
Last name:
3.
Family name:
4.
Date of birth:
5.
Place of birth:
6.
Registered residence:
Voivodeship, postal code, city, street, building number, apartment number
7.
Residence:
Voivodeship, postal code, city, street, building number, apartment number
8.
ID card number and series:
9.
Expires on:
10. Permit to work as a driver in the Netherlands: (underline as appropriate) YES
NO
11. Driver’s license number:
12. Driver’s license expires on:
13. Polish phone number:
14. Dutch phone number:
15. ICE (in case of emergency) phone number
16. E-mail address:
17. BSN/SOFI number: (underline as appropriate) YES
I DO NOT HAVE ONE
(Numer BSN/SOFI)
18. Bank account and SWIFT number:
(The bank account number is required in the recruitment process. The candidate must own or coown a bank account):
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19. Clothing size: (underline as appropriate) S
M
L
XL
XXL
20. Height (in cm):
21. Shoe size:
22. Foreign languages:
I.
English (underline as appropriate)
II.
German (underline as appropriate)
III.
Dutch (underline as appropriate)
IV.
Fluent Communicative Basic
Fluent Communicative Basic
Fluent Communicative Basic
(underline as appropriate)
Fluent Communicative Basic
23. Owned residence in the Netherlands: (underline as appropriate) YES
NO
24. Personal insurance in the Netherlands: (underline as appropriate) YES
NO
25. Benefits received in the Netherlands (now): (underline as appropriate) YES
26. Student status: (underline as appropriate) YES
NO
NO
27. International Student Identity Card (ISIC): (underline as appropriate) YES
NO
(Numer ISIC)
28. Resides with parents: (underline as appropriate) YES
NO
29. Professional progress – WORK EXCLUSIVELY IN THE GARDENING SECTOR
Please fill out the table starting with the most recent workplace and make sure to include all years of employment (even if
you do not have documents confirming employment in your possession or were self-employed).
Employment time
Position
(from-until)
Company name /
City (country)
Detailed description of tasks and
responsibilities
from
until
from
until
from
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until
30. Key professional skills (performed jobs, equipment type, etc.)
31. Other professional qualifications (licenses, courses, etc.)
32. Health conditions against physical labour in the Netherlands
(underline as appropriate) YES
NO
33. Time flexibility (from when, for how long, with who):
Additional required application documents (copies):
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Resume with photo in Polish (alternatively in English)
Scan of valid ID card or passport (in colour, both sides)
Number of bank account (foreign currency or in the Netherlands)
Scan of driver’s license (in colour, both sides)
Scan of BSN/SOFI number assignation
Statement of the candidate:
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I hereby declare that my health allows for employment in the Netherlands to perform physical labour.
I hereby declare that I have provided all information in the application voluntarily and am aware that it is
required for proper performance of the agreement by the Agency;

I have been informed that the requirement of the information in points 1, 2, 3, 4, 5, 13, and 16 results from
art. 221 of the Labour Code in association with art. 5 of the Act on the Employment of Temporary Workers
dated 9 July 2003 (Journal of Laws no. 166, item 1608);
I hereby express consent to the processing of my personal information by For All Seasons Packing sp. z o.o. with
its registered seat in Olsztyn at ul. Malewskiego 14/23, 10-686 Olsztyn in scope required for the recruitment
process, including current and future sharing with potential employers seated outside of the country (in
accordance with the Personal Information Protection Act dated 28 August 1997; Journal of Laws no. 133, item
883);
I have been informed that I am entitled to access and change the provided personal information, to information
on the purpose and scope of its processing, and to demand that it no longer be processed and removed;
I hereby declare that the information in the job application form is true;
I hereby express consent to sharing my personal information for purposes of gaining employment;
I realise that the Agency does not return the submitted documents (copies) and if the application is rejected the
documents are destroyed. I also realise that submission of the form and document translations does not
guarantee employment by a foreign employer.
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location and date
candidate’s signature
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