Full Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Contact Number *

(###)

###

####

Start Date

MM

DD

YYYY

FUSE Club *

Artane

Blanchardstown

Bray

Cork

Finglas

Newbridge

Smithfield

Waterford

HQ

Emergency Contact Name *

First Name

Last Name

Emergency Contact Number *

(###)

###

####

REVENUE Employment Registration *

New FUSE employees must register with MyRevenue via their website and enter the business details below. This will avoid any tax issues if done in advance of your first payroll date. (i.e. final Friday of each month). Company Name: Fortem Capital Ltd Company Reg No: 592077 VAT No: 3443025RH

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