Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Which areas are you interested in?

Request collecting

Studio assisting

Presenting

Other (please specify)

Morning (10-midday)

Evening (7-9pm)

Weekends - circle Sat and/or Sun (10am -midday)

Weekdays - circle weekdays available: Mon Tue Wed Thur Frid (10am -midday and/or 7pm -9pm)

Radio Clatterbridge is committed to safeguarding young people and vulnerable adults in Clatterbridge Health Park. Therefore, membership to the organisation is deemed exempt of the Rehabilitation Of Offenders Act 1974 in relation to sexual offences. Have you ever been convicted of a criminal offences, other than a spent conviction under the Rehabilitation Of Offenders Act 1974? *

Please note: Having a conviction will not necessarily bar you from being offered membership. A satisfactory criminal records check is required for all membership appointments.

Yes

No

Referee 1 Name *

First Name

Last Name

Referee 1 Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Referee 2 Name *

First Name

Last Name

Referee 2 Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I give permission for Radio Clatterbridge to request a reference from at least one of the names above and confirm that I have read the Data Protection Policy (link below). This information and details of disclosures may be shared with the organisations we work in partnership with within Clatterbridge Health Park in line with the Data Protection Act 2018 and the EU General Data Protection Regulation (GDPR).

I Agree