HR Forms - New Starter Form

Employee Details - To be completed by the applicant
Surname:	required
Forename(s):	required
Middle Name:
Title:	required
Preferred Name / Known As:
Gender:	required
Date Of Birth:	required Incorrect Format (dd/mm/yyyy)
National Insurance No:	required
Marital Status	required
Maiden Name:
Address Line 1:	required
Address Line 2:	required
Address Line 3:
Postcode:	required
Home Telephone No:
Mobile Telephone No:
Email Address:
Country of Birth:
Nationality:
Equal Opportunities in Employment This information will only be used for statisical monitoring purposes
How would you describe your Ethnic Origin:	required
Other:
Religion:	required
Other:
Disability:	required
Sexual Orientation:	required

Previous Employment Details
Is this your first employment?	required
Title:
Employer's Name:
Employer's Address:
Start Date:	Incorrect Format (dd/mm/yyyy)
End Date:	Incorrect Format (dd/mm/yyyy)

Work Permit / Visa Details (if Applicable)
Is A Work Permit Required?	required
Permit Number:	required
Permit Expiry Date:	required Incorrect Format (dd/mm/yyyy)
Is A Visa Required?	required
Visa Number:	required
Visa Expiry Date:	required Incorrect Format (dd/mm/yyyy)

Secondary Employment
When you start at Tameside Hospital, will this be your only place of work?	required
If No, please provide details of you secondary employment:	required

RTI (P46 Declaration) - Check the box that applies to you
A. This is my first job since last 6th April and I have not been receiving taxable Jobseekers Allowance, Employment and Support Allowance or taxable Incapacity Benefit or a state of Occupational Pension. B. This is now my only job, but since last 6th April I have had another job, or have received taxable Jobseekers Allowance, Employment and Support Allowance or taxable Incapacity Benefit. I do not recieve a state of Occupational Pension. C. I have another job or receive a state of Occupational Pension. Please select a value from above

Previous Redundancy / Retirement - Enter the date in the box that applies to you, if any
A. I have previously been made redundant from the NHS	Incorrect Format (dd/mm/yyyy)
B. I have previously taken MARS	Incorrect Format (dd/mm/yyyy)
C. I have retired from the 1995 section of the NHS Pension Scheme	Incorrect Format (dd/mm/yyyy)
D. I have retired from the 2008 section of the NHS Pension Scheme	Incorrect Format (dd/mm/yyyy)

Bank / Building Society Details
Bank / Building Society Name:	required
Address:	required


Postcode:	required
Account Number:	required
B/S Roll Number (if Applicable):
Sort Code:	required

NHS Pension Scheme
The Trust operates the NHS Pension Scheme in which you will be automatically opted in
Are you employed elsewhere in another NHS Trust?	required
NHS Start Date:	Incorrect Format (dd/mm/yyyy)

Post Details
Current Notice Period:	required
Proposed Start Date:	Incorrect Format (dd/mm/yyyy)
Are you a newly qualified clinician? (excluding Medical Staff)	required
If Yes, did you work at Tameside as a:
Cadet?	required
Student?	required
Did this influence your decision to work here?	required
Do you hold a mentor/clinical educator qualification?	required
If yes, what type?	required
When did you qualify?	required Incorrect Format (dd/mm/yyyy)
What Level?	required
When did you last update?	required Incorrect Format (dd/mm/yyyy)
Do you require professional registration to undertake your role?
Professional Registration Body:
Professional Registration Number:

Uniform
Do you require a uniform?

System Access
As part of your employment at Tameside NHS Trust, you will have access to a number of IT systems.
Please confirm you have read and understood the IT Acceptable Use Policy required
Smartcard
Do you currently have a Smart Card?	required
If Yes, please can you confirm the UUID (number on the front of the card):	required

Applicant Authorisation
Name:	required
Date:	required Incorrect Format (dd/mm/yyyy)
Email:	required
Contact No:	required