Nederlands
English
Polski
Personal data
First name
Initials
Prefixes
Last name
Date of birth
Place of birth
Land of birth
-
Afghanistan
Algerije
Angola
Argentinia
Armenië
Aruba
Austria
Azerbeidzjan
Belgium
Bonaire, Sint Eustatius en Saba
Brazil
Bulgaria
Canada
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Eritrea
Estonia
Filippijnen
Finland
France
Gambia
Georgia
Germany
Ghana
Greece
Guinee-Bissau
Hungary
India
Indonesia
Iran
Iraq
Ireland
Italy
Jemen
Koeweit
Latvia
Lithuania
Luxembourg
Macedonia
Malta
Mexico
Moldavië
Morocco
Netherlands
Nicaragua
Nigeria
Oekraïne
Pakistan
Poland
Portugal
Republic of Niger
Romania
Russia
Rwanda
Saoedi-Arabië
Sierra Leone
Slovakia
Slovenia
Somalië
South Africa
Spain
Sudan
Suriname
Sweden
Switersland
Syrië
Thailand
Turkey
United Kingdom
Venezuela
Vietnam
Gender
-
Man
Woman
Nationality
-
Afghaanse
Algerijnse
American
Angolese
Argentijnse
Armeense
Australische
Austrian
Azerbajdsjaanse
Belgian
Braziliaanse
British
Bulgarian
Burundische
Chinese
Chinese
Colombiaanse
Cubaanse
Cyprische
Czech
Danish
Dutch
Eritrese
Estonian
Etiopische
Filipijnse
Finnish
French
Gambiaanse
Georgian
German
Ghanese
Greek
Guinese
Hungarian
Indiase
Indonesische
Iraakse
Iraanse
Irakees
Irish
Italian
Jemenitische
Kenianse
Kroatische
Kroatische
Latvian
Lithuanian
Luxembourg
Moroccan
Namibische
Nicaraguaanse
Nigeriaanse
Pakistaanse
Polish
Portugese
Romanian
Russian
Rwandese
Serbian
Sierraleoonse
Slovakian
Soedanese
Somalische
Spanish
Surinamese
Swedish
Swiss
Syrische
Thaise
Togolese
Turkish
Ukrainian
Vietnamese
Zambiaanse
Marital status
-
Divorced
Living together
Married
Single
Unknown
Girl name
BSN
Address Netherlands
Street
House number
Addition
Postal code
Place
Country
-
Afghanistan
Algerije
Angola
Argentinia
Armenië
Aruba
Austria
Azerbeidzjan
Belgium
Bonaire, Sint Eustatius en Saba
Brazil
Bulgaria
Canada
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Eritrea
Estonia
Filippijnen
Finland
France
Gambia
Georgia
Germany
Ghana
Greece
Guinee-Bissau
Hungary
India
Indonesia
Iran
Iraq
Ireland
Italy
Jemen
Koeweit
Latvia
Lithuania
Luxembourg
Macedonia
Malta
Mexico
Moldavië
Morocco
Netherlands
Nicaragua
Nigeria
Oekraïne
Pakistan
Poland
Portugal
Republic of Niger
Romania
Russia
Rwanda
Saoedi-Arabië
Sierra Leone
Slovakia
Slovenia
Somalië
South Africa
Spain
Sudan
Suriname
Sweden
Switersland
Syrië
Thailand
Turkey
United Kingdom
Venezuela
Vietnam
Address country of origin
Address
House number
Addition
Postal code
Place
Country
-
Afghanistan
Algerije
Angola
Argentinia
Armenië
Aruba
Austria
Azerbeidzjan
Belgium
Bonaire, Sint Eustatius en Saba
Brazil
Bulgaria
Canada
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Eritrea
Estonia
Filippijnen
Finland
France
Gambia
Georgia
Germany
Ghana
Greece
Guinee-Bissau
Hungary
India
Indonesia
Iran
Iraq
Ireland
Italy
Jemen
Koeweit
Latvia
Lithuania
Luxembourg
Macedonia
Malta
Mexico
Moldavië
Morocco
Netherlands
Nicaragua
Nigeria
Oekraïne
Pakistan
Poland
Portugal
Republic of Niger
Romania
Russia
Rwanda
Saoedi-Arabië
Sierra Leone
Slovakia
Slovenia
Somalië
South Africa
Spain
Sudan
Suriname
Sweden
Switersland
Syrië
Thailand
Turkey
United Kingdom
Venezuela
Vietnam
Additional information
Driving license
Driving license valid until
Mobile number
Telephone number home country
Email
Identification document type
-
Dutch passport
Foreign passport
Identity card
License
Unknown
Identity number
Identification document validity
Health insurance
-
Achmea
Aegon
Aevitae zorgverzekering
Agis zorgverzekeringen
Amicon zorgverzekering
Ander Zorg
Anova zorgverzekering
Avero Achmea
Azivo
Besured
Bewust zorgverzekerd
CZ
De Amersfoortse
Delta Loyd
Ditzo
DSW
Eigen zorgverzekering
Elvia
FBTO
Fortis ASR
Friesland verzekeringen
Groeneland
Groenland / Achmea
Hema
Holland Zorg
IAK Zorgverzekering
Intermundial
Interpolis Zorgactief
IZA
IZR
IZZ Stichting
Kiemer
Menzis
National Academic
Nationale Nederlanden
Nederzorg
Niet gestart
No Dutch health insurance
NSkiV
Ohra
ONVZ
OOM verzekeringen
OZ Zorgverzekeringen
OZF Achmea
PNO Zorg
Promovendum
PZP
SIZ
SR Zorgverzekeraar
Stad Holland Zorgverzekeraar
Trias Particulier
Trias Zorgverzekeraar
UMC
Unive
VGZ
VPZ Assuradeuren
VVAA
Zekur.nl / Unive
Zilveren Kruis
Zilveren Kruis Achmea
Zorg en Zekerheid
Zorg en Zekerheid SIR
ZorgDirect
Shoe size
-
36
37
38
39
40
41
42
43
44
45
Characteristics
-
Higher vocational education
Intermediate vocational education
Bachelor
Master
HBO
Universiteit
Voortgezet - VMBO
Voortgezet - Theoretisch
Voortgezet - HAVO
Voortgezet - VWO
Bank details
IBAN Number
BIC
Payment to the attention of
ATTENTION! You can only submit an IBAN number when the bankaccount is registered on your
own name
.
Place bank
Country bank
-
Afghanistan
Algerije
Angola
Argentinia
Armenië
Aruba
Austria
Azerbeidzjan
Belgium
Bonaire, Sint Eustatius en Saba
Brazil
Bulgaria
Canada
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Eritrea
Estonia
Filippijnen
Finland
France
Gambia
Georgia
Germany
Ghana
Greece
Guinee-Bissau
Hungary
India
Indonesia
Iran
Iraq
Ireland
Italy
Jemen
Koeweit
Latvia
Lithuania
Luxembourg
Macedonia
Malta
Mexico
Moldavië
Morocco
Netherlands
Nicaragua
Nigeria
Oekraïne
Pakistan
Poland
Portugal
Republic of Niger
Romania
Russia
Rwanda
Saoedi-Arabië
Sierra Leone
Slovakia
Slovenia
Somalië
South Africa
Spain
Sudan
Suriname
Sweden
Switersland
Syrië
Thailand
Turkey
United Kingdom
Venezuela
Vietnam
Foreign language skills
Dutch spoken
-
Not
Moderately
Basic
Good
German spoken
-
Not
Moderately
Basic
Good
English spoken
-
Not
Moderately
Basic
Good
Polish spoken
-
Not
Moderately
Basic
Good
Work experiences
Company name
Place
Telephone number
From
Until
Activities
Reason for leaving
Add extra
Required additional application documents
Curriculum Vitea
Scan van een geldig ID Bewijs of paspoort (voorzijde)
Scan van een geldig ID Bewijs of paspoort (achterzijde)
Scan rijbewijs
Scan certificaat
Kopie Bankpas
Driving license
Driving license A
-
Yes
No
Driving license B
-
Yes
No
Driving license C
-
Yes
No
Driving license D
-
Yes
No
Driving license E
-
Yes
No
Certificates
Forklift truck
-
Yes
No
Reachtruck
-
Yes
No
VCA
-
Yes
No
MIG welding
-
Yes
No
MAG welding
-
Yes
No
TIG welding
-
Yes
No
Recruitment
How did you get in touch with Synergie?
-
Directly
The website
Facebook
Instagram
Friends/Family
PracaNL
Robin Planning
AP Grupa
Hollandia Jobs
I-Work
Multijob
Other
K&S
I declare that I have voluntarily given all the requested information and that they are based on reality.
By signing the registration form I give Synergie the permission to process my personal data within the limits described in the
privacy policy
In accordance with the General Data Protection Regulation, I was informed about my right of access to my personal data, the right to correct it, the portability, the opposition to the processing and the right to the removal of my personal data. I can exercise these rights via the form available on the website www.synergie-ir.nl.
I have read the conditions of the privacy policy and expressly give my permission for the storage of my personal data in a digital database and / or paper.
I agree to the above terms and conditions
