NEW STARTER FORM

Please complete all details on this form.

OK BUILD LTD | CRN: 09550837

Subcontractor details

FULL NAME *

START DATE *

ADDRESS *

SITE NAME

CONTACT TEL NO *

DATE OF BIRTH *

EMAIL ADDRESS *

Legal & Tax

UTR NO *

NI NUMBER *

Nationality *

Do you require a work permit / card to work in the UK? Yes No

Share Code / Work Permit *

Gross payment / Net payment* Gross payment Net payment

Emergency Contact

EMERGENCY CONTACT *

EMERGENCY TEL. No. *

Training & Required Documents

Have you passed your CSCS Health & Safety Test? Yes No

Other industry training / accreditations (please detail)

Upload requirements: CSCS card (front & back), Passport copy, and Proof of address.

CSCS Card – Front *

CSCS Card – Back *

Passport Copy *

Proof of Address *

Upload other cards / certificates (optional)

Medical History

Are you capable of repetitive lifting and bending as required for this employment? Yes No

Do you suffer from any medical condition? Yes No

Have you had any previous medical conditions (e.g., neck or back)? Yes No

Have you ever worked in a dusty occupation (e.g., mining or chemical factory)? Yes No

Any problems working at heights? Yes No

Any problems due to hand-arm vibration syndrome (HAVS)? Yes No

Have you ever had a serious industrial accident? Yes No

Do you consider yourself disabled under the Disability Discrimination Act 1995? Yes No

Are you taking any medication? Yes No

Do you agree to abide by all Health & Safety, Quality & Environmental requirements set by OK BUILD LTD? Yes No

Details for above questions if necessary

Payment (BACS)

Payment for works will be paid by BACS, please complete the details below for this purpose.

Account holder name *

Bank name *

Sort code *

Account number *

Payment reference (optional)

Remittance email (optional)

Declaration

This form MUST be fully completed and copies of all certificates and cards attached and handed into the office BEFORE you can be paid. Any details that are missing will delay payment.

I declare that all the information on this form is correct and true and that I have fully understood what has been asked of me.

I accept the declaration

NAME *

Signature (type your name)

Date *

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