Step 1 of 6 0% Your Title and AddressPlease complete the fields below with your information. Every field with a * is required in order to successfully submit the form. If you have any questions, please contact us.Title*-MrMissMrsMsDrProfLordSirOtherForenames*Surname*Address 1*Address 2Address 3CountyPost Code*Country*-EnglandScotlandWalesNorthern IrelandOtherHome TelephoneMobile Telephone*Email* Your Date of Birth and NationalityPlease complete the fields below with your information. Every field with a * is required in order to successfully submit the form. If you have any questions, please contact us.Date of Birth* DD slash MM slash YYYY Nationality*-BritishAfghanAlbanianAlgerianAmericanAndorranAngolanAntiguansArgentineanArmenianAustralianAustrianAzerbaijaniBahamianBahrainiBangladeshiBarbadianBarbudansBelarusianBelgianBelizeanBenineseBhutaneseBolivianBosnianBrazilianBruneianBulgarianBurkinabeBurmeseBurundianCambodianCameroonianCanadianCape VerdeanCarribeanCentral AfricanChadianChileanChineseColombianComoranCongoleseCongoleseCosta RicanCroatianCubanCypriotCzechDanishDjiboutiDominicanDominicanDutchEast TimoreseEcuadoreanEgyptianEmirianEquatoguineanEritreanEstonianEthiopianFijianFilipinoFinnishFrenchGaboneseGambianGeorgianGermanGhanaianGreekGrenadanGuatemalanGuinea-BissauanGuineanGuyaneseHaitianHerzegovinianHonduranHungarianIcelanderI-KiribatiIndianIndonesianIranianIraqiIrishIsraeliItalianIvorianJamaicanJapaneseJordanianKazakhstaniKenyanKirghizKittian and NevisianKuwaitiLaotianLatvianLebaneseLiberianLibyanLiechtensteinerLithuanianLuxembourgerMacedonianMalagasyMalawianMalaysianMaldivanMalianMalteseMarshalleseMauritanianMauritianMexicanMicronesianMoldovanMonacanMongolianMoroccanMosothoMotswanaMozambicanMyanmareseNamibianNauruanNepaleseNew ZealanderNicaraguanNigerianNigerienNi-VanuatuNorth KoreanNorwegianOmaniPakistaniPalauanPanamanianPapua New GuineanParaguayanPeruvianPolishPortugueseQatariRomanianRussianRwandanSaint LucianSalvadoranSamoanSan MarineseSao TomeanSaudi ArabianSenegaleseSerbian or MontenegrinSeychelloisSierra LeoneanSingaporeanSlovakianSlovenianSolomon IslanderSomaliSouth AfricanSouth KoreanSpanishSri LankanSudaneseSurinamerSwaziSwedishSwissSyrianTaiwaneseTajik orTanzanianThaiTogoleseTonganTrinidadian or TobagonianTunisianTurkishTurkmenTuvaluanUgandanUkrainianUruguayanUzbekistaniVenezuelanVietnameseVincentianYemeniteZambianZimbabweanPassport/ID NumberPassport/ID Country of Issue*-United KingdomAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweNational Insurance Number*Student Loan Repayments?* Yes No Not Sure Where did you find Churchill Knight Umbrella?*-Referred by a Recruitment ConsultantReferred by a ContractorUmbrellacompanies.org.ukFreelance SupermarketContractor UKIT Contracting/Contract EyeOther Affiliate WebsiteSearch Engine (Google, Bing, etc.)Social MediaOtherPlease let us know the name of the contractor who referred you*Please specify:* Your Tax InformationPlease provide us with the following information about your tax affairs.Are you CIS registered?* Yes No What is your Unique Tax Reference (UTR) number?*What is your trading name?Are you VAT registered?* Yes No If you are VAT registered, please upload a copy of your VAT Registration Certificate.* Drop files here or Select files Max. file size: 4 MB, Max. files: 5. Please click on the button to upload your VAT Registration Certificate (photographs, scanned version or PDF only). Please note, you can upload multiple files in the following formats – PNG, JPEG, JPG, DOC, DOCX, PDF. There is a maximum file size of 20MB. Your Banking InformationTo ensure we can pay you on time, please provide us with the following information regarding your banking.Your Bank/Building Society Name*Account Number*Sort Code*Building Society Reference (if applicable) Your Assignment InformationWe need to know some information about your assignment. Please complete the following:Recruitment Agency*Recruitment Consultant Name*Recruitment Consultant Email* Recruitment Consultant Phone*Your Assignment Start Date DD slash MM slash YYYY Is your assignment a fixed term contract or open-ended contract?* Fixed Term Contract Open-Ended Contract As your contract is fixed term, how many months will it run for?*123456789101112131415161718192021222324Your Job Title*What is the name of your end-client - the business you will be working for in this assignment?*Are you paid an Hourly or Daily Rate?* Hourly Daily Hourly Rate of Pay*Daily Rate of Pay* Terms of Service and DeclarationPlease read the following thoroughly and click accept if you are happy to proceed.Your Declaration* I confirm that the information I have submitted into this registration form is accurate.Ongoing Communication* I confirm I am happy to receive information from Churchill Knight Umbrella about my payroll and updates to the service.Churchill Knight Umbrella is partnered with Specialist Financial Advisers. Please let us know if you’re interested in finding out how they can help you increase your wealth. There is no obligation to use their service.* Yes – I want to find out more about how I can increase my wealth. Please pass on my contact details (phone and email) to a Financial Adviser. No – I am not interested in finding out more about how I can increase my wealth. Please do not pass on my contact details (phone and email) to a Financial Adviser. CAPTCHAPhoneThis field is for validation purposes and should be left unchanged. Δ