Personal details

Address details

Your Job Title

Your project

Holiday Pay

Note -If you do not tick either box we will set you up default as Accrued holiday Pay.

Starting Declaration

Your present circumstances

Student Loans

Notes:

These regulations are there to give added protection to workers who, like you, are working through agencies (‘Employment businesses’).Unless you will be working with children or other vulnerable people, you have the right to choose to opt out of these regulations;  if you do,

we will support your decision, and will tell the agency that you and we have jointly agreed to opt out

as between (a) you and us, and (b) the agency, the regulations will not apply for that Assignment.

Some agencies may prefer that you opt out, but they cannot legally insist that you to do so –it is your own free choice.

If you have previously opted out, you have the right to change your mind, and to tell us that you wish to opt back in for the next assignment.

To indicate your preference, please tick ONE of the boxes below,

Either

and (in either case) I authorise you to notify my choice to any Employment business with whom you are contracting for an engagement to be performed by me..

I understand that I can change my mind and give you a fresh instruction at any time, although that fresh instruction will not take effect until I finish working in my current role.

Personal Details

Title: {title}

First Name: {firstName}

Middle Name: {middleName}

Last Name: {lastName}

Gender: {typeA}

Mobile Number: {mobileNumber}

Telephone Number: {telephoneNumber}

Fax Number: {faxNumber}

Email id: {email33}

National Insurance Number:{nationalInsurance}

Date of Birth:{dateOf}

Address: {houseName}, {secondLine}, {town}, {postCode}

Payment Details

Name of Bank or Building Society: {bankbuildingSociety}

Sort Code{sortCode67}

Account Number:{accountNumber68}

Account Name:{accountHolders}

Project Details

Agency Name: {agencyName45}

Consultant:         {searchFor47}

Consultant Email:{consultantEmail}

Start Date:{startDate}

End Date:{endDate}

Daily rate:{dailyRate}

Equal Opportunity Monitoring

Ethnic Category: {pleaseTick}

Disability:         {2Disability144}

Religion:{3Religion}

Agreement to Terms

1. I understand that Reliasys 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 Reliasys via post or by emailing to hr@reliasys.co.uk.

2.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.

3. By signing below, I agree to Reliasys providing references on my behalf to future employers or third parties.

4. I agree for Reliasys to check my personal data and qualifications to work in specific areas, where these are required for compliance with legislation.

5. I agree that all the data supplied on this form is correct and true to the best of my knowledge.

6. I consent to keep Reliasys 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.

7. I agree to provide on request documents and information which will enable Reliasys to make any necessary lawful checks on my eligibility to work in the UK.

For further information please contact Reliasys umbrella solution on 020 3500 2615

Choose the document type from the dropdown list:

Select all the files you wish to upload.
Press upload to send this document to us: