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Application to Join the volunteers of MKHR

Full Name :

Post Code :

Address :

Date of Birth :

Home Telephone No :

Mobile Telephone No :

E-mail address :

Do you consider yourself to have a disability (if Yes give details below) ?

Details of disability

Are you a British Citizen or have Indefinite Leave to Remain in the UK ?

If not then please give details of your current Visa status

Have you EVER been convicted of a Criminal Offence, been issued with a Police Caution, are the subject of a current investigation or are pending a Court appearance ?

If Yes please give full details

Please give us some information about yourself, including your current occupation, why you want to join MKHR and any previous experience you may have had at other Hospital Radio stations etc.

Under NHS rules for volunteer workers, we require details of TWO Referees. These should be people who know you either in a personal of professional capacity for at least two years. Please ensure that all fields are completed.

Full Name :

Post Code :

Address :

Date of Birth :

Home Telephone No :

Mobile Telephone No :

E-mail address :

First Referee

Second Referee

Declaration by Applicant
Thanks for completing the Application Form. By pressing the Submit button below you are confirming that :-
    The information given is correct and accurate at the time of completion of the form
    You are over 18 years of age
    You will abide by the NHS Rules and Regulations for volunteers working within the hospital
    You agree to submit to a Criminal Records check
    You agree to pay an annual membership fee to MKHR (£36.00 or £18.00 for the unwaged)

Realtionship to you :

Please complete ALL sections of this form.
Applicants MUST be over 18 years of age. We do not accept applications for work experience from students.