Apprentice New Starter Information – Please complete and send back to HR

Personal Details
Title (Miss, Ms, Mrs, Mr, Dr): / Address line 1:
*Surname: / Address line 2:
* First names: / Town:
Preferred name: / County:
Previous Names (if any): / Post Code:
Date of Birth: / Telephone:
NI Number: / Mobile:
Personal E-Mail: / Marital Status:
Bank/Building Society Details for payroll / Job Details
Bank/Building society name: / Job Title: Finance Apprentice
Bank/Building society branch: / Start date:
Account holders Name: / End date (where applicable):
Bank Sort Code: / Work Location:
Bank Account No: / Salary:
Building Society Roll Number: / Department: Apprentice E59
Email address for payslip / Line Manager:
Staff number:
Emergency Contact details
Name:
Contact number:
Relationship to you: / Name:
Contact number:
Relationship to you:
Dependants
Name:
Relationship to you:
Date of Birth / Name:
Relationship to you:
Date of Birth:
Nationality Which category best describes the ethnic group to which you belong: (2001 Consensus categories)
q  White British
q  White English
q  White Scottish
q  White Irish
q  White and Black Caribbean
q  White and Asian
q  White and Black African
q  Other White background (please specify)
q  Black or Black British African / q  Black or Black British Caribbean
q  Any Other Black Background ( please specify)
q  Asian or Asian British Pakistani
q  Asian or British Indian
q  Asian or Asian British Bangladeshi
q  Any other Asian background
q  Chinese
q  Any other mixed background
q  Any other ethnic group

In line with the Data Protection Act 1998, CIPFA will process the data supplied on this form for the purpose of exercising its statutory and business functions. CIPFA may disclose information to third parties where it is required or permitted to do so by law.

I confirm that the details provided are accurate and I hereby give my consent to CIPFA processing the data supplied for business purposes. I understand that it is my responsibility to update any changes to my personal details via MyHY oe by contacting the HR Department.

Sign ……………………………………………………………………… Date …………………………………………..