Please fill in all details below to the best of your knowledge and then email the information over to


All Starter forms need to be in before the 22nd of the Month for payment on the last working day of the month. If not all hours worked will be added to the following month’s payroll.


The Culcheth Arms Employee Form:



Home Address:

Date of Birth:

National Insurance Number:

Mobile Number:

Home Number:

Email Address:

Job Title:

Rate of Pay:

Start Date:

Employee Signature:

Bank Details for Payment:

Name on Account

Sort Code

Account Number



P46 Declaration;



A – This is my first job since April 6th and I have not received Job Seekers Allowance or Employment & Support Allowance.     YES.    NO.



B – This is now my only job but since April 6th I have had another job/received Job Seekers Allowance or Employment & Support Allowance.     YES.    NO.



C – As well as this job, I have another Job or receive a pension or other income. YES.    NO.    



Have you left a course of Higher Education and received UK Student Loan? YES.    NO.    



Are you repaying your Student Loan?     YES.    NO.



Emergency Information:





Emergency Contact 1:


Relation to Above:

Contact Number:

Emergency Contact 2:


Relation to Above:

Contact Number:

Additional Information:


Please note any time off that you need before starting your position within The Culcheth Arms, all dates noted will be granted, any dates that are requested off after handing this form in will be put through the Holiday Procedure.

Availability to Work;

Please note your availability to work as we will use those available when extra shifts appear and holiday cover is required.