Membership Contact Agent

Please complete the form below.

Title *

First name *

Surname *

Date of birth

Email address *

Contact number *

Job applied for *

CV *

Statement of suitability/Cover letter *

Where did you hear about this job? *

If selected for an interview, do you have any reasonable adjustments for us to consider to support you?

If you answered “yes” please let us know what adjustments you need

Do you have a lived experience of disability and/or long-term health condition

If yes, and you are happy to share,what effect or impact does your disability or health condition have on your work?

As part of the process, you’ll need to confirm your eligibility to work in the UK. Click on the plus to expand

Some examples of acceptable proof includes:

a British passport
an Irish passport or passport card
UK birth or adoption certificate
an Irish birth or adoption certificate
a certificate of registration or naturalisation as a British citizen
a share code
immigration documents

Further information can be found: www.gov.uk/prove-right-to-work

If successful, you’ll be required to provide original copies of this documentation.

Do you have the right to work within the UK? *

Have you ever been convicted of a criminal offense, including driving offenses? (Note: Spent convictions under the Rehabilitation of Offenders Act 1974 need not be disclosed.) *

If you answered “YES,” please state the offences

Please sign the form below, click plus to expand:

By signing below you agree the following:

I confirm that the information provided in this form is accurate and complete.
I understand that withholding information or providing false/misleading details may result in rejection of my application or, if appointed, dismissal, and potential legal consequences.

Please add your full name to accept you agree with the statement above *

Date *