New Chaperone Application Form

New Chaperone Application Form

Please complete the form below to apply for a position with us.
Full Name

First NameLast Name
Birth Date

DayMonthYear
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal Code
Email Address
example@example.com
Phone Number
Mobile Phone NumberFormat: 00000000000.
Are you available for full-time or part-time work?
Do you have access to reliable transportation?
Do you hold a valid Chaperone License? (Yes/No):
License Number:
Issued by:
DBS Check (Yes/No):
If yes, provide the DBS Number:
Date of Issue:
Have you completed any relevant training (e.g., first aid, child safeguarding)?
If yes, please list relevant training, with dates
Do you have previous chaperone experience?
If yes, please describe your experience (including any relevant film/TV productions):
Available Start Date

MonthDayYear
Please upload your Chaperone Licence & your NSPCC certificate

Cancelof
Should be Empty: