Sterling Umbrella Logo

Thank you for enquiring to become a Sterling Umbrella employee. Please fill in this form ensuring that all the shaded sections are completed.

1. About You

Title:
First name:
Middle name:
Surname:
Date of birth:
Male: Male        Female: Female
National insurance number:
Job title:
Please note it is your responsibility to inform us of any change in job title or description
Nationality:
Home telephone number:
Mobile number:
Email address:
Professional qualifications held: *Send certificates/CV
Permanent address:
Address Line 1:
Address Line 2:
Town/City:
County:
Postcode:
Country:
Mailing address: ( click to use permanent address )
Address Line 1:
Address Line 2:
Town/City:
County:
Postcode:
Country:
2. Payment Details - Is your bank account within the UK? Please select an option Yes: Yes        No: No
Name of bank/building society:
Branch location:
Sort code: - -
Account number:              
Roll number (if applicable):
Name of account holder:
Please check the details above before submitting your application as Sterling cannot be held responsible for monies released to incorrect bank details.
3. Agency Details
Agency name:
Branch location:
Contact telephone number:
Name of consultant:
Agency start date:
4. About the Assignments
Is the assignment?
UK based
Uk Based
Abroad
Abroad
Offshore
Offshore
How long will the assignment last?
0-3 Months
0-3 Months
3-6 Months
3-6 Months
6-9 Months
6-9 Months
9 Months+
9 Months+
How would you classify the assignment?
Trade
Trade
Technical
Technical
Professional
Professional
Rail
Rail
Clerical
Clerical
Medical
Medical
Education
Education
5. Security Information

To ensure that your financial and personal details are only discussed with yourself, we require a security password. We will request this each time you contact us. Your security password must be no more than 15 characters.

My chosen confidential password is:
Repeat password:
Mother's maiden name:
Town of birth:
Name of last school attended:
6. How did you hear about us?
Agency
Agency
Colleague/Workmate
Colleague
Previously used us
Previously Used
Online
Online
Communications (e.g. advertising)
Communications
7. Next of Kin Details
Next of kin name:
Home telephone number:
Mobile number:
Please tick this box if you would like to nominate your next of kin to be able to speak on your behalf at times regarding personal information such as your payments.  Signed:   Confirm Statement
8. Holiday Pay Option
Sterling Umbrella Limited offer a flexible holiday pay system, either Contractor Retained Holiday Pay (this is paid out weekly to you) or Company Retained Holiday Pay (we pay you when you are on holiday or request your holiday pay).
Which is your preferred option? (please tick)   Contractor Retained Holiday Pay     Company Retained Holiday Pay  
9. Sterling Umbrella Mortgage Assistance
Sterling recommends Faraday Mortgage Associates Ltd for help and assistance with mortgage & insurance advice
I would like a representative from Faraday Mortgage Associates to contact me to discuss by email   email   and/or phone  phone
10. Criminal Convictions

Under the rehabilitation of offenders act 1974 you are required to give details of any convictions which are not ‘spent’. Failure to do so may render you liable to summary dismissal should you be appointed.

Have you ever been convicted of a criminal offence? Yes   Yes   No  No   If yes, please give details:
Date of conviction:
Sentence imposed:
11. Insurance

With Sterling Umbrella you are covered by our Employers Liability, Public Liability and Personal Accident Insurance. Information relating to the cover, limitations and exclusions of each policy are available here.

12. Confirm you have downloaded and understood the Health and Safety handbook

The Health and Safety handbook details our policies and procedures for Sterling Umbrella employees.

"I acknowledge I have read and understand the contents of the Health and Safety handbook and agree to comply with the policies and procedures contained within it."

Signed:   Confirm Statement   By checking this box you are agreeing to the above statement.
Date: 26/09/2017

If you wish for us to send you a paper copy, please tick here Confirm Statement

13. Medical
General Medical Council (GMC)
PIN:
General Dental Council (GDC)
PIN:
Health and Care Professions Council (HCPC)
PIN:
Nursing and Midwifery Council (NMC)
PIN:
14. Contract of Employment

We require confirmation that you have agreed to the Sterling Umbrella Contract of Employment. You will have the opportunity to read the contract after submitting your application and previous employment forms. Upon agreeing to the terms, you will receive a confirmation e-mail with a copy attached for your records.

15. Eligibility to Work in the UK (ETW)

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

  • 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 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.

For Romanian, Bulgarian and non EU nationals requirements, please refer to the ETW guide.

16. Data Protection

All data we hold about you and how we process and use it complies with the data protection act. From time to time, we may offer services or products which we feel may benefit you through carefully selected third parties e.g. accountancy services or mortgage advice.

17. Tax Code

To ensure we process your payments with the correct tax code, we require parts 2 & 3 of your P45, which should have been issued by your last employer or agency. Unfortunately HMRC will not allow us to accept a scanned copy of this document, so please post this to us at the address below. If you do not have a P45, our joining team will be in touch shortly to obtain further details regarding your last employment.

18. Employee Statement
Yes
A - This is my first job since 6 April and have not been receiving taxable Jobseeker's Allowance, Employment and Support Allowance, taxable Incapacity Benefit, State or Occupational Pension.
No
B - This is now my only job but since last 6 April I have had another jon, or received Jobseeker's Allowance, Employment and Support Allowance, taxable Incapacity Benefit. i do not receive a State or Occupational Pension.
Yes
C - As well as my new job, I have another job or receive a State or Occupational Pension.
‘I have a Student Loan which is not fully repaid and I left a course of UK higher education before last 6 April and I received my first Student Loan installment on or after 1 September 1998. Select ‘No’ if you are repaying your Student Loan direct to the Student Loans Company by agreed monthly payments. ’
Yes: Yes        No: No
19. Declaration

"I declare that the information I have provided is correct and I understand that it is my responsibility to inform Sterling Umbrella of any changes to my job title, personal, bank or agency details as soon as possible. Providing incorrect or false information on this application form may result in the company invoking disciplinary procedures that may end in dismissal. I also confirm that it is my intention to undertake multiple assignments and will inform Sterling Umbrella should my intentions change. I also agree to the terms and conditions set in the contract of employment "

Signed:   Confirm Statement   By checking this box you are agreeing to the above statement.
Date: 26/09/2017
Supporting Documents

Please could you upload documentation for the following:


If you do not have electronic copies of the above documentation, we will require paper copies. Please return these either by




You must agree to the statements in sections 11 and 16 before submitting this application.

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