C19 vaccine program site supervisor enquiry form | South Sefton Primary Care Network

I am interested in signing up as a Covid vaccination program site supervisor

I am happy to work free of charge
I am seeking a paid role

Please indicate the approximate commitment you could make to the program

Name *

First

Last

Date of birth *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Phone *

Do you have the right to work in the UK and are you able to provide documentary evidence? *

Employment status *

Knowing your current employment status helps speed up our HR process in getting participants started as quickly as possible.

If employed please state employer and current position/ role

Do you have any UNSPENT convictions, cautions, reprimands or final warnings as outlined in the Rehabilitation of Offenders Act 1974? *

Answering 'yes' to this question will not necessarily bar you from appointment. This will depend on the information you provide and the position you are applying for. Please note a DBS application or current DBS check is performed on all applicants

Do you have any SPENT convictions, cautions, reprimands or final warnings as outlined in the Rehabilitation of Offenders Act 1974? (copy) *

Answering 'yes' to this question will not necessarily bar you from appointment. This will depend on the information you provide and the position you are applying for. Please note a DBS application or current DBS check is performed on all applicants

Comments/Questions

COVID VACCINATION PROGRAM-SITE SUPERVISOR ENQUIRY FORM