Personal information

First name

Last name

Gender

Nationality

Date of birth

Place of birth

Country of birth

Citizen service number (BSN)

Bank account number (IBAN)

BIC

Passport photo

Communication

Mobile number incl. country code

Communication language

If you are proficient in multiple languages, you can indicate this by checking the box below and filling in the fields that appear.

Yes, I speak multiple languages.

In case of emergency

Name of contact person

Phone number incl. country code

Identification

Type of identification document

Identification number

Valid until (identification)

Identification front

Identification back

Health insurance

Do you have coverage through the Dutch health insurance?

(Privately arranged or through Pater Broersen with Zilveren Kruis)

Health insurance company name

Health insurance document

Driver's license

Yes, I have a driver's license.

No, I do not have a driver's license.

Dutch address

Yes, I have a Dutch address.

No, I do not have a Dutch address.

Foreign address

Yes, I have a foreign address.

No, I do not have a foreign address.

Clothing

T-shirt size

Sweater size

Jacket size

Pant size

Shoe size

Preferences

Below you will find a section where you can indicate your preference for the number of working hours. Please understand that this is just a preference. We want to emphasize that these preferences allow us to better understand your ideal work scenario. While we cannot always guarantee all preferences, we will do our best to take this information into account when planning tasks.

How many hours per day would you ideally like to work?

How many days per week would you ideally like to work?

How many months per year would you like to work with us?

Do you intend to work for our company for multiple years?

What is your ambition within Pater Broersen?

What is your ambition outside Pater Broersen?

Do you have family members who would also like to work here?

This information can be filled in voluntarily.

Work experience

Company name

From

Place

Duties

Education / Courses

Institute

From year

Name

Until year

Place

Country

If you have obtained the diploma, please upload it.

Diploma obtained?

Upload diploma