Step 1 of 5 0% Your Choice of ServicePlease let us know which Bluebird Umbrella service you want to join by answering the question below.I want to join:* Bluebird Essential (£7.50 per week) Bluebird Extra ( £15.00 per week) 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 2 Address 3 County Post 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 Number Passport/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 Bluebird Umbrella?*-Referred by a Recruitment ConsultantReferred by a ContractorIT Contracting / Contract EyeUmbrellacompanies.org.ukFreelance SupermarketContractor UKIT Contractors UKOther Affiliate WebsiteSearch Engine (Google, Bing, etc.)Social MediaOtherPlease let us know the name of the contractor who referred you* Please specify:* 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* 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.Terms and Conditions of Service* I accept the terms and conditions of service.Your pay and your holiday pay will be determined in accordance to the National Minimum Wage and Working Time Directive. Bluebird Umbrella will deduct our margin from your pay as agreed and you are confirming you are happy for us to do this. Bluebird Umbrella must have confirmation of your working hours and rates, supported with a correctly signed timesheet before you receive your payments. We will not send you any funds until we have received your funds from your recruitment agency/end client. Bank Holidays may affect you receiving your payments on schedule. Bluebird Umbrella run payroll daily (Monday to Friday) and will pay you in accordance to your agreed schedule when all the necessary processes from yourself have been completed and we have received your funds into our account. Bluebird Umbrella will not negotiate changing your payment frequency and we do not hold onto your funds once we have received them. You must contact your recruitment agency to change your payment schedule. By submitting this form, you are confirming that you have had no incidences that could bring Employers’ Liability or Public Liability insurance into effect since your first communication with Bluebird Umbrella and the submission of this form. Any previous and current cases regarding possible insurance claims that you are involved in have been discussed with Bluebird Umbrella prior to submitting this form.Your Declaration* I confirm I understand the information provided and I have completed this form accurately.I understand how Bluebird Umbrella works and have a full understanding of the processes involved. When I am officially an employee of Bluebird Umbrella, I understand my payments will be sent to my bank account from Bluebird Umbrella (as my employer). When I send this completed form to my recruitment agency or directly to Bluebird Umbrella, I consent to Bluebird Umbrella storing and using my personal and sensitive data. I also accept that my information may be passed on to third parties such as Trade Unions and providers of contractor insurances if required. I confirm that I have completed this form accurately and have provided the correct information. I have/will provide Bluebird Umbrella with a photocopy of my passport and a contract of employment that I have read, understood and signed. I confirm that Bluebird Umbrella can contact my recruitment agency and/or end client and share information directly related to my assignment. I understand that completing this form does not automatically make me an employee of Bluebird Umbrella. I will only become an employee of Bluebird Umbrella when both parties (Bluebird Umbrella and myself) have signed a contract of employment. I understand that by signing and submitting this document to my recruitment agency or directly to Bluebird Umbrella that I accept the terms and conditions and the declaration.Ongoing Communication* I confirm I am happy to receive information from Bluebird Umbrella about my payroll and updates to the service.NameThis field is for validation purposes and should be left unchanged.