COVID SUPPORT WORKER ROLE APPLICATION
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IMPORTANT NOTE:

Thank you for requesting an Application Form to support the needs of the service in this unprecedented time. If you require assistance with this form, please contact 01274 437373.

Please read ALL enclosed information, particularly COVID 19 advice, DBS guidance, right to work and the role profile.

Applicant
Applicant first name(s)*
Surname(s)*
*
Home phone number
Mobile number
Email address*
National Insurance*
Date of Birth*
Preferred hours of work*
What hours are you available during the week, evenings and weekends?

Do you have access to a vehicle that could be used for work purposes?

The role may require the postholder to drive around the district however if you do not have access to a vehicle or cannot drive, please do not let this deter you from applying, as there will be be other opportunities as part of this role.
Type of Driving Licence

Employment Status*


Highest Level of Qualification*








Eligibility to work in the UK*
Emergency Contact Name
Emergency Contact Number
Relationship to You


Please supply the names and details of two individuals who may be contacted for work related references. If you have not been employed, provide an academic and character reference.

Reference 1
Name*
Position*
Relationship to you*
Organisation*
Address*
Contact Number*
E-mail*


Reference 2
Name*
Position*
Relationship to you*
Organisation*
Address*
Contact Number*
E-mail*