EMPLOYEE/CONTRACTOR REGISTRATION FORM

PLEASE COMPLETE YOUR PERSONAL DETAILS BELOW. Date: / /

05051990 Job Title: labourer First Names: nick Surname:harding Address:6
colebrooke rise mays hill road Tel Home: _______________________Tel
Mobile: ______________________Email
address: ____________________________________UTR/CIS No:
________________________Postbr2 0nx Code: CSCS or 05519500 april 2022
________________________Date of Birth: 05051990 / / CPCS No:
_______________________National jr131887d Expiry Date:// Insurance No:
EMERGENCY CONTACT/NEXT OF KIN
Relationship to Next of Kin: _______________mother_________________First
Name: _______________jackie_____________________Surname:
_____________herriot_________________________________Daytime
Tel:07954376614 Mobile Tel:07954376614 Do you suffer from any health
problems/allergies?YES NO Please tick If yes, please give details: Are you
currently taking any medication?YES No Please tick If yes, please give details:
BANK DETAILSBank Name: metro Branch: PRINT IN BLOCK
CAPITALS PRINT IN BLOCK CAPITALS Sort Code: 230580 Account
No:15001151 Account Payee Name:
_________________________________________________________ PRINT IN
BLOCK CAPITALS MR N A HARDING Building Society Reference Number:
_________________________________________________________ I
CONFIRM ALL THE ABOVE DETAILS ARE TRUE AND
CORRECT: Signature:
______NHARDING________________________________Print Name:
_________NICK HARDING___________________________ PRINT IN BLOCK
CAPITALS