UKREMT Application Form

UKREMT CORPORATE PARTNER REGISTRATION

All application data is GDPR & HIPAA Compliant
MD / Registered Manager - Person Responsible for Registration
Full Name *

Prefix First Name Last Name
Pin Number: *
If not a member please enter your registration pin form HCPC, NMC or GMC
Registration Scheme of the Registered Manager *
If you are not a registrant of HCPC / NMC / GMC you will need to register with the UKREMT
ID Attached *

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Photo ID (NHS or Company ID, Passport or Driving Licence) Cancel of
We need a full correct CURRENT company address & email to ensure your renewal pack reaches you via post, email address is to ensure we can correspond with you quickly at all times about your corporate partner registration and any FTP issues with your staff registrants plus for changes that may happen with the UKREMT.

We require both your registered office address and your operating base address this is to ensure correct due dilligence and full contact and disclosure of our registrants.

It is important that you are accurate with you number of employees as this will affect the ££ value of discount codes available to your company.
Number of Employees & Contractors *

1 - 10 11 - 50 51 - 100 100 +

Company Registered Address *

Street Address
Street Address Line 2
City	County
Post Code	Country

Registered Address same as Operating Base *

YES NO - See Below

Company Operating Base Address

Street Address
Street Address Line 2
City	County
Post Code	Country

Company E-mail *
Company Phone Number *

Area Code Phone Number
Type of registration appling for *
It is important that you are accurate with you number of employees as this will affect the ££ value of discount codes available to your company.

Corporate Partner Registration Payment *

EMS Corporate Partner Registration (0-10 Employees) ( £ 100.00 GBP for each year )

0 - 10 Employees / Contractors

EMS Corporate Partner Registration (11 - 50 Employees) 2 ( £ 200.00 GBP for each year )

11 - 50 Employees / Contractors

EMS Corporate Partner Registration (51 - 100 Employees) 3 ( £ 400.00 GBP for each year )

51 - 100 Employees / Contractors

EMS Corporate Partner Registration (100+ Employees) 4 ( £ 800.00 GBP for each year )

100+ Employees / Contractors

Non-EMS Corporate Sponsor Registration £480 ( £ 480.00 GBP for each year )

£480

OVERSEAS Coporate Partner Registration (EMS & Non-EMS) ( £ 500.00 GBP for each six months )

£1000 PA : Overseas Coprorate Partners are welcome if they support our aims and goals. We do though ask them to sign up for 4 years as it requires greater audit times to set them up : payable in 2 instalments every 6 months.

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TERMS & CONDITIONS / FITTNESS TO PRACTICE
Please agree to application T&Cs to continue application: *

1. Agree for corporate registration to be made public on the UKREMT website. 2. Agree to read, sign and abide by the Fitness To Practice policy document as a condition of corporate partner registration (Downloadable from the UKREMT website at www.ukremt.co.uk/fitness-to-practice) FTP Pages 15 & 16 will need to be attached to this application and signed by the registered manager. 3. Agree to abide by the EMT Code as put forward by the UKREMT which can be found on our website (www.ukremt.co.uk). 4. Agree to ensure that all employees not registered by the HCPC, NMC or GMC are registered with the UKREMT via our online application form www.ukremt.co.uk in the HIVE - All your staff will get a company discount code for 20% off registration. 5. Agree to pay all your own fees (legal and otherwise) in relation to both this application and ongoing registration this includes and appeals or fitness to practice hearings. 6. Agree under GDPR to recieve emails from UKREMT in relation to your comapnies application and registration. 7. Agree that all monies paid are non-refundable once you appear on the corporate registration page, not part of funds will be refunded even if are removed from the register for company FTP issues or failing to register your staff. 8. Agree to promote the UKREMT its Aims and Goals to your client base and the wider market place.
Signed Fitness To Practice (FTP) is attached: *

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Pages 15 & 16 Only required to be signed by the registered manager or MD. Cancel of

SIGNATURE
Any additional information you feel would enhance your company partner registration application please feel free to add it below or send this in a sperate email - with the subject line "Additional Corporate Partner Registration Information" to partners@ukremt.org.
Additional Information:
I authorised the verfication of all the information on this form, for UKREMT audit team to verify my details for corporate partner registration and FTP.

Must be signed by the registered manager or MD
Signature Name *

First Name Last Name
Signature *
By submitting this form you agree that all the information contained in it, is accurate to the best of your knowledge and accept that a submission is made regardless of if form is signed and the submission itself will be accepted as your electronic signature.

Soon as your registration is live you will receive a 100% discount code for the MD or Registered Manager and a 20% discount code for all other staff and contractors that can only be used up to your employee / contractor numbers declared.
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UKREMT CORPORATE PARTNER REGISTRATION