New Starter Induction Form

Please complete this form in full so that we can register you as a new employee with Poppies and add you to payroll.

Full Name * Email * Address * Which Poppies branch are you interested in? * Altrincham & Hale Bays & Lakes Bradford Camden London Chester Chorley & Wigan Clapham Cumbria Doncaster Durham Exeter Gloucestershire Hackney, Tower Hamlets, Lewisham, Greenwich, Bexley Harrow Hounslow Leeds Liverpool Mayfair & Hampstead Mercia Newcastle Nottingham East Ormskirk, Southport & Formby Peak District Preston Sheffield Solihull Southampton & Winchester Southend South Manchester South Tyne Stockport St Albans Tyne Coast Richmond Romford & Grays Waford & Hatfield Walthamstow Warrington Warwick Wilmslow Macclesfield Wirral York Other Head Office Your Job Title Will you be providing cleaning in your role at Poppies? Yes No Your Date of Birth National Insurance Number * Employee statement: You need to select only one of the following statements A, B or C * This is my firs job since 6 April and I have not been receiving taxable Jobseeker's Allowance, Employment and Support Allowance, Taxable Incapacity Benefit, State or Occupational Pension This is now my only job but since last 6 April I have had another job, or received taxable Jobseeker's Allowance, Employment and Support Allowance or Taxable Incapacity Benefit. I do not receive a State or Occupational Pension As well as my new job, I have another job or receive a State or Occupational Pension Student Loan: Do you have a Student Loan which is not fully repaid? * Yes (if yes, go answer the next 2 question) No (if no, miss the next too questions) What type of Student Loan do you have? Plan 1 (You will have a Plan 1 Student Loan if:• You lived in Scotland or Northern Ireland when you started your course, or • You lived in England or Wales and started your course before September 2012) Plan 2 (You will have a Plan 2 Student Loan: if you lived in England or Wales and started your course on or after 1 September 2012) Did you finish your studies before the last 6 April? Yes No Name on Bank Account * Account Number * Sort Code * Address of Bank * Have you submitted your P45? * Yes No Emergency Contact Person * Their relationship to you * Emergency Contact Number * Do you have a disability? Yes No Please provide details of any medical conditions that you believe we should be made aware of Date * I understand that the above information will be held by Poppies for the use of my employment * Yes Submit