Forms to complete for Induction

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Name Of Account Holder (as it appears on your card) *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Email *

Phone *

Bank Details

Name of account holder (as it appears on your card) *

Name of bank *

Account Number: *

Sort Code:

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Your Details

Name *

Details of main emergency contact

Name of First Emergency Contact *

First

Last

Ralationship to you *

Please select the relationship you have to this emergency contact

Address of emergency contact

Address Line 1

City

State / Province / Region

Postal Code

Phone number of emergency contact

Details of alternative Emergency contact

Name of First Emergency Contact *

First

Last

Ralationship to you *

Please select the relationship you have to this emergency contact

Address of emergency contact

Address Line 1

City

State / Province / Region

Postal Code

Phone number of emergency contact

Tax Information

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Name: *

First

Last

Address: *

Address Line 1

City

State / Province / Region

Postal Code

Date of Birth: *

National Insurance number:

Start date:

Employee Statement

You need to select only 1 of the following statements: *

This is my first job since the last 6th April and i have not been receiving taxable jobseeker's Allowance, Employment and Support Allowance, taxable Incapacity Benefit or State or occupational Pension.
This is now my only job, but since the last 6th of April I have had another Job or recieved taxable Jobseekers Allowance, Employment and Support Allowance, taxable Incapacity Benefit or State or occupational Pension.
As well as my new job, I have another job or receive a State or Occupational Pension.

Student Loan

1. Do you have a student loan which is not fully repaid? *

Yes (if yes go to question 2)
No (if no go to question 4)

2. Are you repaying your Student Loan direct to the Student Loan company?

Yes (if yes, go to question 4
No (if No, go to question 3

3. Student loan Plans: What type of Plan do you have?

Plan 1
Plan 2

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. You will have a Plan 2 Student Loan if You lived in England or Wales and started your course on or after September 2012.

4. Did you finish your studies before the last 6th of April. *

Expression of wish form

Beneficiary 3

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The Care Afloat Group Life Assurance Policy:

All employees of Care Afloat are eligible to this scheme and it is paid for by the company and no contributions are expected from employees. The ‘death in service scheme’ means that one year’s salary or £20,000 (whichever is higher) will be paid to a nominated beneficiary in the event of your death whilst you are employed by us.

By completing this form you declare that you understand that the Trustees of Care Afloat Limited Death in Service Scheme have the power to select a beneficiary or beneficiaries to receive certain lump sum benefits payable on your death, if payment of any such lump sum benefits should fall due and understand that this request is not binding on the Trustees.

Beneficiaries:

You are able to divide the total benefits between beneficiaries, if you wish to do so.

Layout

Name: Beneficiary 1 *

Realtionship to myself

Percentage of total benefits i would like this beneficiary to recieve

Selected Value: 0

Address

Address Line 1

City

State / Province / Region

Postal Code

Section Divider

Layout (copy)

Name: Beneficiary 2

Realtionship to myself (copy)

Percentage of total benefits i would like this beneficiary to recieve (copy)

Selected Value: 0

Address

Address Line 1

City

State / Province / Region

Postal Code

Section Divider

Layout (copy)

Name: Beneficiary 3

Realtionship to myself (copy)

Percentage of total benefits i would like this beneficiary to recieve (copy)

Selected Value: 0

Address

Address Line 1

City

State / Province / Region

Postal Code

Section Divider

Layout

Name: Beneficiary 4

Realtionship to myself (copy) (copy)

Percentage of total benefits i would like this beneficiary to recieve (copy) (copy)

Selected Value: 0

Address

Address Line 1

City

State / Province / Region

Postal Code