Format: AA 999999 A
Re-employed pensioner form
Employer's name and department
Free text
Employee reference / payroll number
Free text
Free text
Please choose date (dd/mm/yyyy)
Please indicate the type of contract
Fixed period
Full-time
Part-time
Retained / casual
Annual rate of pay at date of leaving 1st post
£
Actual annual rate of Pay in 2nd post at appointment
£
Employer contact details for further information
Name
Telephone number
Email address
Additional notes