Sessional Worker Application Form

Sessional Worker Application Form

Any information will be treated in the strictest confidence. Please use capitals for easy reading.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of birth *

DayMonthYear
Date
Contact Phone No*

Area CodePhone Number
Email*
example@example.com
Emergency contact (next to kin)*

First NameLast Name
Emergency contact number?*
Please enter a valid phone number.
Emergency contacts address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Health conditions ( please detail any health conditions that you have below )
Medications ( please list all medications you are taking incase of an emergency)
Do you have SEND or ADDITIONAL NEEDS? Please give further details of any support we can offer you while you are working at the charity.

What is your availability for Working*

Rows	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Morning
Afternoon
Night

Please tell us about any previous voluntary or sessional work you have done, which is relevant to the role.
Your skills relevant to the role (please list any skills you have below)
DriverPlay workerYouth workerFootball coachCookery food workerCyclingWalkingEvents assistantGardeningChristmas workerElderly events workerKeep fit workerFundraising worker
Please add dates and training course below
Have you completed any relevant training for this role? Please upload any certificates you may have.

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REFERENCES**:

In order to protect our clients, we need to take up references. Referees cannot be family members and must have known you a minimum of 2 years. Please note that if your circumstances mean you are unable to provide referees who have known you for 2 years, please give details of two professional people who have known you for at least six months.(Doctor , support worker, social worker or immigration officer, etc...)
Reference 1

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
How does this person know you?
Reference 2

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
How does this person know you?
please upload a copy of reference here (admin only)

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Please upload a copy of your DBS check.

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DISCLOSURE AND BARRING CHECKS:

Depending on the nature of the sessional work,you may be asked to undertake a disclosure and barring service check.
Disclaimer**
Please note, this electronic signature acts as your signature as this form has been completed online.
Payment and Invoices**

By signing this application, I understand that my role of Sessional Worker, if successful, will be on a self-employed basis and will submit weekly time sheets, together with an invoice for hours on the 4th Friday of every month.

I am responsible for my own tax and insurance obligations.
Signature*

Clear
Date*

DayMonthYear
Date

Type a question

Rows	Reference form sent	Reference form 1 received	Reference form 2 Received
For office use

Type a question

Rows	DBS SENT	DBS RECEIVED	DBS SUCCESSFUL
For office use only

Should be Empty: