APPLICATION FORM
Registered Charity No 275620
Name (Mr / Mrs / Miss/ Ms) : ________________________________________________________
Address : ______________________________________________________________________
_______________________________________________
Post Code : _____________________DOB; ___________________
Home Tel: ___________________ Mobile: __________________EMail : _____________________________
Occupation: _________________________________Where did you find out about Hospital Radio Wey?
Do you have any previous broadcasting or relevant experience? Yes / No
Would you be able to tow our Outside Broadcast caravan? Yes / No Are you a car owner? Yes / No
Why are you interested in joining Hospital Radio Wey ? (continue overleaf if necessary)
INDICATE BELOW WHICH SUBJECTS YOU ARE INTERESTED IN:
MUSIC PROGRAMMES [ ] (MUSIC TYPE PREFERRED): _____________________________
SPEECH PROGRAMMES [ ] RECORD LIBRARIAN [ ] SPORTS PROGRAMMES [ ]
FUND RAISING [ ] TECHNICAL / ENGINEERING [ ]
REQUEST COLLECTING [ ] OTHER (PLEASE SPECIFY) ______________________________
REGULAR AVAILABILITY – Please circle when you are available
WEEKDAY EVENINGS
: MON TUE WED THU FRISATURDAY : MORNING AFTERNOON EVENING
SUNDAY : MORNING AFTERNOON EVENING
Once accepted by Hospital Radio Wey, your application to join us will be subject to approval by the
Ashford & St. Peter’s NHS Trust, who will request a Criminal Records Bureau check on your details.
New trainees are asked to support the running of Hospital Radio Wey through an Annual Subscription.
You will also be asked to sign membership terms & conditions, which can be viewed at
www.radiowey.co.ukYou may elect to sign a Deed of Covenant which allows the organisation to reclaim tax.
Signed: ________________________ Date: ________________________
Chairman: ________________________ Secretary: ________________________
TEMP NO.
FULL M/SHIP NO.
BR / ASSOC / OTHER
SUBS PAID
DATE
SECRETARY USE