• About You

  • Date of Birth *
     / /
  • Do you require a work Permit?*
  •  -

  • Payment Details

  • CIS Status & UTR Details

  • Are you VAT register?*

  • Agency Details

  • Agency start date*
     - -

  • About the Assignment

  • Is the assignment?*
  • How long will the assignment last?*
  • How would you classify the assignment? (*If Medical, please also submit details in section 11)*

  • Next of Kin Details

  • 7 How did you hear about us?
  • Date
     - -

  • Medical

  • Please complete the following section if contracting within the medical sector only.

  • Please tick all memberships that apply and provide your PIN numbers where applica

  • 10. KYC Documents

    We require KYC documents to confirm you are eligible to work in the UK. Include one of the following with your registration:

    • Your original passport or a photocopy countersigned by a professional or manager. Countersigned passports must clearly show the image, passport details and the signature. The person countersigning your passport copy must provide their full name, job title and date of signature.
    • A national identity Proof of Address – Please provide any one document - Council tax bill, a copy of utility bill, Driver’s License or Correspondence from HMRC card photocopy countersigned by a professional or manager.

    If you do not have a passport and you are a British or Irish national please provide the following:

    • A full birth certificate and a recent HMRC document.

    11. Declaration

    • I understand that Sprypay holds data about me for certain purposes, including (but not limited to), confirming entitlement to work in the UK, managing personnel and pay records as judiciously required to operate its business. I understand that I can request and have access to this data (subject to applicable exclusions) by contacting Sprypay via post or by emailing to info@sprypay.co.uk.
    • By signing this application form, I provide my consent to the processing of my personal and /or sensitive personal data as described above. Further, I approve to such data being released to third parties (such as insurance providers/payroll processing) where necessary for the foregoing purposes.
    • By signing below, I agree to Sprypay providing references on my behalf to future employers or third parties.
    • I agree for Sprypay to check my personal data and qualifications to work in specific areas, where these are required for compliance with legislation.
    • I agree that all the data supplied on this form is correct and true to the best of my knowledge.
    • I consent to keep Sprypay informed in writing of any changes in my personal details, contact details and any changes in my personal circumstances which might affect my immigration status and eligibility to work in the UK and to supply any such information on request.
    • I agree to provide on request documents and information which will enable Sprypay to make any necessary lawful checks on my eligibility to work in the UK.
    • Please note we conduct Anti-Money Laundering (AML) check of your Identity and Address proofs submitted to us for compliance purposes.
  • Date
     - -

  • 12. Self-employed Assessment

    This assessment is required to enable Sprypay to assess your self-employment status and determine that you are not under Supervision, Direction and Control

    Please answer all of the following questions in respect to your services, whether by reference to Sprypay, the agency or the client.

  • As a self-employed sub-contractor ....

  • Would you be entitled to Holiday pay, sick pay, a company pension schemeor other such benefits?*
  • Are you responsible to complete, either yourself or via an accountant, an annual self-assessment tax return?*
  • Are you responsible for all your own expenses in relation to travellingto/from site and/or overnight accommodation?*
  • Are you under any obligation to accept or receive future assignments from the Agency?*
  • Do you have the freedom to contract on more than one assignment at anyone time and choose the hours you work taking into account assignment deadlines and opening hours of the client’s site*
  • Once given basic instructions of what to do for your day, will anyone else advise you how to complete these tasks?*
  • Will you be under constant supervision by anyone whilst undertaking yourrole?*
  • Do you understand that a suitably qualified alternative contractor can be supplied as a substitute to complete a task that you have been assigned to,should you be unavailable for any reason?*
  • Do you provide your own tools, equipment and/or PPE to carry out your assignments?*
  • Do you receive training with the exception of H&S training from anyone you currently provide services to?*

  • “I acknowledge that the responses I have provided in this questionnaire are a true and accurate description. The responses I have given apply to terms and conditions of my engagement with Sprypay.”

  • Date*
     - -
  • Should be Empty: