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Voornaam/Name *


Tussenvoegsels


Achternaam/Surname *


Roepnaam/Given name *


Voorletters/Initials *


Nationaliteit/Nationality *
AfghanAfricaAlbanianAlgerianAmericaAmericanAndorranAngolanAntigua And BarbudaArgentinianArmenianAsiaAustralianAustrianAzerbaijaniBahamianBahrainiBarbadianBelarusianBelgianBelizeanBengaliBeninsBhutaneseBolivianBosnianBotswanaBrazilianBritishBruneiBulgarianBurkineseBurundianCambodianCameroonianCanadianCape VerdeCentral AfricanChadianChileanChineseColombianComorianCongoleseCongolese (Democratic Republic)Costa RicanCroatianCubanCypriotCzechCzechoslovakDanishDjiboutianDominicaDominicanDutchEcuadorianEgyptianEquatorial GuineaEritreanEstonianEthiopianEurope (excluding Dutch)European Union (excluding Dutch)FijianFinnishFrenchGaboneseGambianGeorgianGermanGhanaianGreekGrenadianGuatemalanGuineaGuinea-BissausGuyaneseHaitianHonduranHungarianIcelandicIndianIndonesianIranianIraqiIrishIsraeliItalianIvorianJamaicanJapaneseJordanianKatareseKazaksKenyanKiribatianKosovarsKuwaitKyrgyzLaoLatvianLebaneseLesothanLiberianLibyanLiechtensteinsLithuanianLuxembourgishMacedonianMadagascanMalawianMalaysianMaldiveMalianMalteseMarshall IslandsMauritanianMauritianMexicanMoldovanMonegasqueMongolianMontenegroMoroccanMozambicanMyanmareesNamibianNauruanNepaleseNew ZealandNicaraguanNigereesNigerianNorth KoreanNorwegianOceaniaOmanitePakistaniPanamanianPapua New GuineaParaguayanPeruvianPhilippinePolishPortugueseRomanianRussianRwandanSaint Kitts And NevisSaint LucianSaint Vincent And The GrenadinesSalvadoranSamoanSan MarineseSao Tome And PrincipeSaudi ArabianSenegaleseSerbiaSerbia And MontenegroSeychelsSierra LeoonsSingaporeanSlovakSlovenianSolomon IslandsSomaliSouth KoreanSouth SudaneseSouth-AfricanSoviet RussianSpanishSri LankanStateless / UnknownSudaneseSurinameseSwaziSwedishSwissSyrianTaiwaneseTajikTanzanianThaiTimor LesteTogoleseTonganTotal Non-Dutch NationalityTrinidad And TobagoTunisianTurkishTurkmenTuvaluanUgandanUkrainianUnited Arab EmiratesUruguayanUzbekVanuatuanVaticanVenezuelanVietnameseYemeniYugoslavianZambianZimbabwean

Geslacht/Sex *
—Kies een optie—Man/MasculinVrouw/Feminin

Burgerservicenummer (BSN)/Citizen service number


Burgerlijke staat/Civil status
—Kies een optie—Ongehuwd/UnmarriedWettig gehuwd/MarriedPartnerschap/PartnershipVerweduwd na wettig huwelijk/Widowed after legal marriageVerweduwd na partnerschap/Widowed after partnershipGescheiden na wettig huwelijk/DivorcedGescheiden na partnerschap/Separated from partnership

Geboortedatum/Date of birth *


Geboorteplaats/Place of birth *


Geboorteland/Country of birth *
AfghanistanAlbaniaAlgeriaAndorraAngolaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCanadaCentral African RepublicChileChinaColombiaComorosCongo-BrazzavilleDemocratic Republic of the CongoCook IslandsCosta RicaCubaCuraçaoCyprusDenmarkDjiboutiDominicaDominican RepublicGermanyEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiPhilippinesFinlandFranceGabonGambiaGeorgiaGhanaGrenadaGreeceGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIrelandIndiaIndonesiaIraqIranIsraelItalyIvory CoastJamaicaJapanYemenJordanCape VerdeCameroonKazakhstanKenyaKyrgyzstanKiribatiKuwaitKosovoCroatiaLaosLesothoLatviaLebanonLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMaldivesMalaysiaMaliMaltaMoroccoMarchall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMozambiqueMyanmarNamibiaNauruNetherlandsNepalNicaraguaNew ZealandNigerNigeriaNiueNorth-KoreaNorwayUgandaUkraineUzbekistanOmanEast-TimorAustriaPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPolandPortugalQatarRomaniaRussian FederationRwandaSolomon IslandsSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSloveniaSlovakiaSudanSomaliaSpainSri LankaSão Tomé and PríncipeSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSurinameSyriaTajikistanTaiwanTanzaniaThailandTogoTongaTrinidad and TobagoChadCzech RepublicTunisiaTurkeyTurkmenistanTuvaluUruguayVanuatuVatican CityVenezuelaUnited KingdomUnited Arab EmiratesUnited StatesVietnamBelarusZambiaZimbabweSouth AfricaSouth KoreaSouth SudanSwedenSwitzerland

Telefoonnummer/Phone number *


E-mailadres/Email address *


Straat/Street


Huisnummer + toevoeging / Number


Postcode/Zipcode


Woonplaats/ Place of residence


Woonland/Country of residence *
AfghanistanAlbaniaAlgeriaAndorraAngolaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCanadaCentral African RepublicChileChinaColombiaComorosCongo-BrazzavilleDemocratic Republic of the CongoCook IslandsCosta RicaCubaCuraçaoCyprusDenmarkDjiboutiDominicaDominican RepublicGermanyEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiPhilippinesFinlandFranceGabonGambiaGeorgiaGhanaGrenadaGreeceGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIrelandIndiaIndonesiaIraqIranIsraelItalyIvory CoastJamaicaJapanYemenJordanCape VerdeCameroonKazakhstanKenyaKyrgyzstanKiribatiKuwaitKosovoCroatiaLaosLesothoLatviaLebanonLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMaldivesMalaysiaMaliMaltaMoroccoMarchall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMozambiqueMyanmarNamibiaNauruNetherlandsNepalNicaraguaNew ZealandNigerNigeriaNiueNorth-KoreaNorwayUgandaUkraineUzbekistanOmanEast-TimorAustriaPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPolandPortugalQatarRomaniaRussian FederationRwandaSolomon IslandsSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSloveniaSlovakiaSudanSomaliaSpainSri LankaSão Tomé and PríncipeSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSurinameSyriaTajikistanTaiwanTanzaniaThailandTogoTongaTrinidad and TobagoChadCzech RepublicTunisiaTurkeyTurkmenistanTuvaluUruguayVanuatuVatican CityVenezuelaUnited KingdomUnited Arab EmiratesUnited StatesVietnamBelarusZambiaZimbabweSouth AfricaSouth KoreaSouth SudanSwedenSwitzerland

Rekeningnummer/Bank account number


Begunstigde/Bank account holder


In welke branche(s) bent u geïnteresserd? Which industry(s) are you interested in?

PluimveeSchoonmaakLogistiek & TransportMagazijnProductie
Wilt u loonheffingskorting toepassen?/Do you want to apply a payroll tax credit? *

?

JaNee

Wilt u de zorgverzekering laten toepassen? *

JaNee

Heeft u een arbeidsverleden bij Uitzendwerk?/Do you have an employment history with Uitzendwerk? *

JaNee

Wilt u een kopie van uw inschrijving in uw mailbox ontvangen?/Do you want to receive a copy of your registration in your mailbox?

JaNee

Algemene voorwaarden *

Ja, ik ga akkoord met de algemene voorwaarden
Met deze inschrijving bij Uitzendwerk houden wij u op de hoogte over werkende werkplekken. Daarnaast kunnen uw gegevens gebruikt worden om een aangeboden werkplek om te zetten in een contract. / With this registration at Uitzendwerk we keep you informed about workplaces. In addition, your data can be used to convert an offered workplace into a contract.
Lees onze / Read our privacyverklaring.
Alle velden met * zijn verplicht om ingevuld te worden/ All fields with * are mandatory