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Interim Manager Registration

To register as an Interim Manager, please complete the form below with your details. If you have any questions or queries, please do not hesitate to contact Ginette Langston, Administrator on 01926 834700 or by email to Nicola.andrews@dbiconsulting.co.uk.

Your Details

Your Name   Mandatory
Home Address   Mandatory
Home Telephone Mandatory
Mobile Telephone   Mandatory
Text Alerts: Would you like to receive a text alert when a new Interim requirement is received by Dbi?
If so please confirm the mobile number below.
Confirm Mobile Telephone
Fax Number Mandatory
Email Address   Mandatory
Re-Enter Email Address
Date Of Birth
Nationality
Do you hold a current, 10 year British passport?
Please provide a copy of your passport to include your photograph, date of birth and signature

Your Company/Umbrella Company

Limited Company Name
Registration Number
Company Address
Telephone
Email Address
If you do not have a Limited Company, please confirm which Umbrella company you will be contracting through.

Availability and Daily Rate

Availability  
Daily Rate  

References

Please be aware that the names of two referees will be requested and contacted prior to any contract engagement.

Security Clearance

Have you ever been security cleared?
If so, to what level?
Which company cleared you?
Contact Name
Contact Telephone
Valid From to

Personal Circumstances

Do you know of any personal circumstances that a client might wish to be advised of, and which might affect your suitability? (Examples might include UNSPENT criminal convictions, matters relating to immigration requirements or work visas.
If yes, please provide details
Are you subject to immigration control in the UK?
If so, do you currently have the right to enter or remain in the UK?
Please provide copies of any work permits required

Main Areas Of Expertise

This section has been designed to give you the opportunity to summarise and highlight the areas that you believe are your specialist areas.

Your specialist keywords (up to a maximum of eight) can be made up of position titles, application areas and/or sectors. For example:

Programme Manager / Change Management / Health / Central Government / Implementation / Procurement / E-Government.

If your only specialist areas are Defence and Procurement, please do not feel as though you need to fill in the other boxes!

These words will not reduce the number of requirements you are considered for, only enhance your specialist areas. Your CV and keywords will be used alongside each other to resource requirements, so please be assured that additional experience and qualifications detailed on your CV will not be ignored.

*Key Words/Specialist Areas – please complete at least four of the boxes

Please provide copies of education and industry related qualification certificates.

Miscellaneous

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