Canvasser application form
First name(s)
Last name
Date of Birth
Telephone number
Mobile number
Preferred areas of
work e.g. Oxted,
Caterham, Lingfield
or ‘any’
Please note: canvassers will be allocated according to our requirements. There is no
guarantee that canvassers will be allocated to their area or choice, but every effort will be
made to allocate you to that area or nearby.
Are you eligible to work in the UK? Yes
Previous Experience
Please give details of any relevant experience involving door-to-door deliveries, knocking
or customer service and dealing face-to-face with the public. This could be previous voter
registration canvassing either in Tandridge or elsewhere, or Census work or similar.
Do you work for Tandridge District Council?
Yes No
Protection of residents
During the canvass you will be working with minimal direct supervision and will be calling
on individual residents of the district, some of whom could be vulnerable. Have you been
convicted of a criminal offence, or been subjected to a caution or bind-over or do you have
any prosecutions pending?
Yes No
If yes, please provide details
Data Protection (GDPR)
As part of our recruitment process, Tandridge District Council collects and processes
personal data relating to job applicants. This data will be confidentially destroyed 12 months
after the selection takes place.
I understand that my personal data will be used for recruitment purposes
would like to be considered for canvass duties. I accept that work will involve weekend and
evening working. I understand I must complete the work to a standard set by the Electoral
Registration Officer to qualify for payment.
declare that I have not, am not, and will not assist anybody else with a campaign for any
parliamentary, local, European or parish election, nor do I occupy any position in connection
with a political party or organisation.
am available to make personal calls to households between 1 September and 31 October
confirm that all the information provided on this form is correct and complete.
am entitled to work in the UK
Please return the completed form to or
Democratic Services, Tandridge District Council, Council Offices, 8 Station Road East,
Oxted, RH8 0BT.
click to sign
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Equal Opportunities Monitoring Form
In accordance with its policy on equal opportunities in employment, Tandridge District Council will provide
equal opportunities to any employee or job applicant and will not discriminate either directly or indirectly
because of race, sex, sexual orientation, gender reassignment, religion or belief, marital or civil
partnership status, age, disability, or pregnancy and maternity.
In order to assess how successful this policy is we have set up a system of monitoring all job applications.
We would therefore be grateful if you would complete the questions on this form. We have asked for your
name to enable us to monitor applications at shortlisting and appointment as well as application stage.
The questions in this form reflect the categories "protected groups" identified in the Equality Act 2010.
They also reflect questions asked by the National Census which means we can compare our workforce to
the local population.
All information will be treated in confidence and will not be seen by staff directly involved in the
appointment. The questionnaire will be detached from your application form, stored separately and used
only to provide statistics for monitoring purposes.
Data collected on applicants who are unsuccessful will be confidentially destroyed 6 months after the
selection process takes place.
Thank you for your assistance.
ame: ___________________________________________________________________________
Post: ____________________________________ Department:______________________________
Please tick the relevant box
Date of birth: ____________________
2 Gender:
le [ ] Female [ ] Unspecified [ ]
3 G
ender Identity:
Do you live and work fully in the gender role opposite to that assigned at birth?
[ ] Yes [ ] Do not wish to disclose [ ]
4 Marital status:
il Partner [ ] Divorced/Separated [ ] Married [ ]
artner [ ] Single[ ] Do not wish to disclose [ ]
Sexual Orientation:
Please indicate, if you wish, which category below best describes you:
isexual [ ] Gay [ ] Hetrosexual [ ] Lesbian [ ] Do not wish to disclose [ ]
6 Ethnic Origin
to which of the following groups would you say you belong?
lack African Black African Black Caribbean Chinese White UK
[ ] [ ] [ ] [ ] [ ]
ixed Other [ ] White Other [ ] Other [ ]
7 Language
What is your first language?
8 Religion
Please indicate, if you wish, which of the groups listed below you most identify with:
Baha’i [ ] Buddhist [ ] Christian [ ] Hinduism [ ]
udaism [ ] Muslim [ ] Rastafarian [ ] Sikhism [ ]
religion [ ] Do not wish to disclose [ ]
9 Disability
The Equality Act 2010 states that "a person has a disability for the purposes of the Act if he/she has
a physical or mental impairment which has a substantial and long term adverse effect on his/her
ability to carry out normal day-to-day activities".
Please indicate whether or not you consider yourself to be a disabled person using the drop down
list below:
abled [ ] Not disabled [ ] Not known [ ] Not stated [ ]
Disability description______________________________________________________________
re you a carer of a family member or a friend because of their age or disability?
Yes [ ] No [ ]
Please return the completed form to or
Democratic Services, Tandridge District Council, Council Offices, 8 Station Road East,
Oxted, RH8 0BT.
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