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Title

First name^*

Last name^*

Email^*

Password^*

Password Confirmation^*

Nationality^*

Upload Selfie^*

Client / Agency^*

Are you happy for SHMS Contracting to share your data with the Client / Agency?^*

Yes

Trading Status: Tick as applicable^*

Sole Trader

Ltd Company

Partnership

National Insurance Number^*

Unique Tax Reference Number^*

Have you registered under the CIS scheme by calling HMRC on 0300 200 3210?

Address1^*

Address2

Town^*

County

Postcode^*

Have you lived at this address for more than 3 years?^*

Yes

Date of birth^*

Home tel

Mobile tel^*

Name of Bank or Building Society

Branch

Sort Code^*

Sort Code Confirmation^*

Account No^*

Account No Confirmation^*

Account Holder’s Name^*

Account Holder’s Name Confirmation^*

Roll Number (for Building Society account)

Next of kin

Next of kin contact No

Next of kin relationship

CSCS/CPCS card?^*

Yes

Qualifications/Experience^*

Years worked in the construction industry^*

Signed (Full Name)^*

Do you agree with the Terms of Engagement

Terms of engagement (Full Name)^*

Do you agree with the Self-employed Status Declaration

Self-Employed Status Declaration (Full Name)^*