LECI Group - Registration

Name: *

D.O.B: *

Nationality: *

Passport No: *

Address: *

Post Code:

Contact Tel Number: *

Email: *

Trades:

CSCS/CPCS No:

Expiry Date:

Previous experience:

UTR No:

NI No:

Bank details:

Bank Name:

Bank Account No:

Sort Code:

Next of Kin/Emergency Contact:

Name:

Contact Tel No:

Do you agree to work as a self-employed sub-contractor for Leci Group ?
YES NO

Do you have any medical conditions or take any medication that may affect your ability to work?
YES NO

Do you confirm you have the right to work in the UK?
YES NO

Do you consent to your information being stored and used by Leci Group as required for employment and for contacting you and making your payments?
YES NO

Uk Registration

Bank details:

Next of Kin/Emergency Contact: