Sterling Techserv Logo

Thank you for enquiring to become a Sterling Techserv sub-contractor. 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:
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. UTR Details
Unique tax reference number (UTR):    (Sole traders only)
Account name:
Trading name:
Are you VAT registered?:    Yes: Yes        No: No   If you answered yes, please provide a copy of your VAT registration certificate.
4. Agency Details
Agency name:
Branch location:
Contact telephone number:
Name of consultant:
Agency start date:
5. About the Assignment
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
6. 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:
7. Next of Kin Details
Next of kin name:
Home telephone number:
Mobile number:
8. How did you hear about us?
Agency
Agency
Colleague/Workmate
Colleague
Previously used us
Previously Used
Online
Online
Communications (e.g. advertising)
Communications
9. Insurance

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

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

The Health and Safety handbook details our policies and procedures for Sterling Techserv contractors.

"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: 14/12/2017

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

11. Medical
General Medical Council (GMC)
PIN:
General Dental Council (GDC)
PIN:
Health and Care Professions Council (HCPC)
PIN:
Nursing and Midwifery Council (NMC)
PIN:
12. Contract for Services

We require confirmation that you have agreed to the Sterling Techserv Contract for Services. You will have the opportunity to read the contract after submitting your registration form and self-employed assessment. Upon agreeing to the terms, you will receive a confirmation e-mail with a copy attached for your records.

13. 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 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 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.

14. 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.

15. Declaration

"I declare that the information I have provided is correct and I understand that it is my responsibility to inform Sterling Techserv of any changes to my job title, personal, bank or agency details as soon as possible. I also understand that if I have provided details that relate to an account not held in my name, e.g. spouse, and the relationship between the account holder and myself breaks down, Sterling Techserv cannot be held responsible for any payments to the nominated account. I also agree to the terms and conditions set in the contract for services."

Signed:   Confirm Statement   By checking this box you are agreeing to the above statement.
date: 14/12/2017
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 10 and 15 before submitting this application.

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