Target Umbrella

Applying to Target is simple. Get the ball rolling by completing the form below and you could start benefiting before your next pay day.

Your Details
Title*
Name*
First Last
Address*
Street Address City ZIP / Postal Code Country
Phone*
Email*
Date of Birth*

DD
MM
YYYY
PPs Number*
Tax Code
Date

DD
MM
YYYY
Profession*
We require a P45 from your previous employer in order to proceed with your application.
- If you do not have a P45 and require a P46 please tick the box.
Notes and Special Circumstances:
Key Identifiers
Mother's Maiden Name*
This is required for additional security purposes
Father's First Forename*

Current Contract Details
These are the details of the recruitment agency or client that you are currently working for.
Contract Start Date

DD
MM
YYYY
Agency
Agency Contact Name
Agency Address
Agency Telephone
Agency Fax
Agency E-mail
End Client
End Client Contact Name
End Client Address
End Client Telephone
End Client Fax
End Client E-mail
By completing the above details you confirm that Assura may contact the above named Agency/ End-Client with my consent, and that the above named Agency/ End-Client is hereby authorised to release and/ or discuss my personal data/ records held on their files for the purpose of Assura completing the necessary arrangements to take over my current contract with that Agency/ End-Client and/ or for the purpose of collecting data relating to my previous work/ employment history from that Agency/ End-Client.

How did you hear about us?
WHISPER IN THE SANDS If you were referred to Assura by an existing employee of Assura please provide their name and (if known) reference below to ensure that they are rewarded through our Employee Reward Scheme if you are successful in your application for employment.
Name
First Last
Reference
Or was it some how else?
Untitled
If other please provide
Name of salesperson you have had contact with
By clicking submit you confirm that you are applying for employment with Assura, and that the information here given is true and correct. You understand that the Company will use my personal data for employment administration, payroll, administrative and customer services purposes, and authorise its provision to employees and agents of the Company for these purposes in accordance with the Irish Data Protection Act. You are entitled to request a copy of your personal data held on our files at any time.

Finally