Job Form

Personal Information

Last Name (* Required field)  

First Name(s) (* Required field)  

If Other, Please state.  

Home Address (* Required field)  

Home Postcode (* Required field)  

Home Telephone (* Required field)  

Mobile Telephone (* Required field)  

Email Address (* Required field)  

Date of Birth (dd/mm/yy) (* Required field)  

National Insurance Number. (* Required field)  

Availability (Mark all appropriate boxes)

• Training sessions held between 29 September – 11 October

• Collection of Canvass Forms and other equipment from Electoral Services on 16 or 17 October

• Door knocking from 16 October to 10 November

• Hand delivery of 'Final Reminder' Forms to outstanding properites between 13 November - 16 November

• Return of Stationery and Equipment by 17 November

• I am not available for these dates but would like to be considered in the future

Any other notes about your availability.  

If you are an RBK employee, please fill in the following

Directorate  

Section  

Work Address  

Work Postcode  

RBK Email Address  

Work Telephone Number  

Pay Number  

For all Applicants

If not, which authority?  

New Applicants Only

Which ward(s) would you like to work? (Refer to the Ward map available at the top of this form - note that Electoral Services may not be able to give you canvass areas in your specified Wards but will, where possible, try to meet your requests)  

For Applicants who have worked on previous canvasses Only

If no, which wards would you like (refer to the Ward Map - Note that Electoral Services may not be able to give you the canvass areas in your specified Wards but will, where possible, try to meet your requests).  

Recruitment Monitoring Form

You must complete this section in order for your application to be considered.

Ethnic Background - I would describe myself as

If Other Asian Background, please state:  

If Other Black Background, please state:  

If Other Mixed Background, please state:  

If Other White Background, please state:  

If Other Ethnic Group, please state:  

Please note: The responses to the above questions do not form part of the employment application, but it is necessary to collect this information from all applicants. The information collected on this part of the form is used for statistical purposes only.

Note: As you are returning this form by email, you will be required to sign and date a copy before commencing employment.