Full Intake

Thank you for choosing Pollux! To ensure that we have the correct information in your personnel file, we would like to ask you to complete this intake form very carefully. This way we can work together to ensure that we have all the right information to enable you to work for our clients. We also need all the correct information for correct salary.

Should you have any questions while filling out the form, you can ask our staff for further explanation.

We wish you a nice time at Pollux!

Personal

Questions with (!) are required

Gender

Initials

First name

Insert

Last name

Maiden name

Marital status

Date of birth

Birthplace

Nationality

Do you have a BSN?

Yes

You have indicated that you still have a BSN document. We would like to receive a copy of the BSN document when you sign your employment contract. We need the BSN for salary purposes.

On what date was your BSN issued?
The date you have to fill in below concerns the issue date of the original document of your BSN and not the issue date of a duplicate BSN document.

Why is the first issue date so important? The date of first issue is necessary to determine whether Pollux Personeelsdiensten B.V. may apply the ET scheme (scheme for extraterritorial costs) for you, and for how long it may still be applied. The ET Scheme, which is included in Article 20 of the NBBU Collective Labor Agreement for Temporary Workers, is a tax scheme that allows employees living abroad and temporarily working in the Netherlands to receive a tax-free allowance for extra costs they incur because they are temporarily working outside their country of origin.

Country of birth

You have indicated that you still have a BSN document. We would like to receive a copy of the BSN document when you sign your employment contract. We need the BSN for salary purposes.

Yes, I have the official BSN document

No, but have a duplicate of the BSN document

No, I dont have the BSN document anymore

You have indicated that you have a BSN number but no longer have a BSN document.

Even if you do not have your BSN document, can you indicate below the date your first BSN document was issued?

Why is the first issue date so important: The date of first issue is necessary to determine whether Pollux Personeelsdiensten B.V. may apply the ET scheme (scheme for extraterritorial costs) for you, and for how long it may still be applied. The ET Scheme, which is included in Article 20 of the NBBU Collective Labor Agreement for Temporary Workers, is a tax scheme that allows employees living abroad and temporarily working in the Netherlands to receive a tax-free allowance for extra costs they incur because they are temporarily working outside their country of origin.

Contact information

Communication at Pollux is mostly digital. For example, you receive your schedule on an app on your phone and you sign your contract digitally which you can find back in your personal portal.

Therefore, it is important that you enter your
personal mobile number
and your
personal email address
below.

Phone number

Mobile phone

E-mail

Address

Street

Number

Addition

Postal code

City

Country

Accommodation

I have my own accommodation

I would like to use the accommodation provided by Pollux

Are you already registered with a municipality in the Netherlands (BRP-Basisregistratie Personen)?

Yes

Street

Number

Addition

Postal code

City

Country

Work Experience and Successive Employment

It is important that you enter the information below correctly and completely. The information you enter here may be important for the terms of employment you qualify for and your legal status. For example, we need your employment history in order to scale you correctly for your salary.

There may also be successive employership. Successive employership occurs when you perform the same or similar work for another employer within a reasonable period of 6 months. If this is the case, we must, for example, fit this employment history into the phase system. You cannot derive any rights from successive employership if you have deliberately provided incorrect or incomplete information about your employment history to Pollux Personeelsdiensten B.V.

Starting	Till	Employer	Location	Agency name (if applicable)	Job function	Today
No work experience added yet

Add experience to table

I currently work here

Languages

Indicate below your proficiency in languages

Language skill level: Dutch

Language skill level: English

Language skill level: Spanish

Language skill level: German

Language skill level: French

Language skill level: Italian

Language skill level: Croatian

Language skill level: Polish

Language skill level: Romanian

Upload CV

Browse

ICE Contact

Please fill in below which person we can contact in case of an emergency.

Name

Phone number

Relation

What is your Relation?

Other

Are you a student?

Yes

How would you like to arrange your health insurance?
(If you are privately insured, we would like to receive a copy of your health insurance card when (possibly) signing your employment contract).

I am privately insured

I want to use Pollux's health insurance policy

Do you hold an International Student Identity Card (ISIC)?
If you hold an ISIC Card, we ask that you give us a copy when you sign your employment contract.

Yes

What size T-shirt do you have?

Shoe size

How did you find out about Pollux?

Please enter your comment(s) here:

Complete the following only if it is NEEDED for the performance of the work. If it is not necessary then do not complete any further medical information.
Are there industries where you cannot work because of the physically demanding conditions there? Consider industries that work:

under low or high temperatures;
working with hazardous substances;
working in a dusty environment.

If so, can you indicate what physically taxing conditions we should take into account? For example, allergies to a certain substance.
Are there any circumstances of which your workplace colleagues should be aware? If so, can you indicate what your colleagues should do in such a circumstance? Consider epilepsy, for example.

Please note: this only applies to circumstances that are necessary for your Pollux coordinator and your colleagues to know, so that they are informed and know what to do if necessary. And in addition, this can be taken into consideration when scheduling you with one of our clients.

Yes

Availability

It is important to us that we take your availability for work into account and make good arrangements around your availabilty together.

When we are planning your workschedule, we expect that:

- You are available Monday through Sunday and that
- You are available for work between 00:00 and 24:00.

When scheduling your work, we also take into account the rules set forth in the Arbeidstijdenwet.

Are you willing to work in shifts?

Yes

Are you willing to work for multiple clients?

Yes

Do you agree with the statement above?

Yes, I agree

No, I don't agree. Enter your limited availability below:

I am available on Mondays FROM

UNTIL

I am available on Tuesdays FROM

UNTIL

I am available on Wednesdays FROM

UNTIL

I am available on Thursdays FROM

UNTIL

I am available on Fridays FROM

UNTIL

I am available on Saturdays FROM

UNTIL

I am available on Sundays FROM

UNTIL

Ambitions

We believe it is important that our employees can develop themselves. We are happy to help you with that. Below you can indicate the ambitions you have.

We think it's important for our employees to be able to develop. We would like to help you with that. Below you can indicate what ambitions you have.

Education

Please indicate below you highest education and, if applicable, the type of education( e.g. veterinarian, administrative assistant, account manager)?

Highest level of education

What did you study?

Hobby's

What do you enjoy doing in your spare time?

Fill in your Hobbies below

Terms & Conditions

I agree with the conditions above