Application form

Personal details

Preferred title *

First name *

Surname *

Address *

Postcode *

Email address

Telephone number *

What's your relationship with GreenSquareAccord? *

Customer Panel membership

Were you a member of either the legacy North or legacy South Customer Panel? *

Yes

Please indicate your eligibility for the GreenSquareAccord Customer Panel by checking the below boxes *

I am over the age of 18

I live in a GreenSquareAccord property

I am not a GreenSquareAccord employee, Board or Committee Member

Previous experience

Why are you interested in being a Customer Panel member? *

Please tell us about your knowledge, skills and behaviours and how these could help the Panel develop a customer focused approach that is representative of GreenSquareAccord's diverse customer base? *

Please briefly describe your IT skills and any areas where you would need support or training *

Criminal convictions history

Possession of a criminal record will not necessarily prohibit an offer to carry out this role and will only be considered if the applicant is selected for interview, in which case it will be considered in terms of risk management and safeguarding customers.

Do you have any criminal convictions, cautions, reprimands, final warnings, etc that are not spent under the Rehabilitation of Offenders Act 1974? *

Yes

If Yes, please give details, including date(s) and nature of offence(s)

Other opportunities to get involved

From time to time, we would like to tell you about opportunities to get involved with GreenSquareAccord.

If you are happy to be contacted about future opportunities, please let us know by ticking this box

I am happy to be contacted about future opportunities

Privacy

Any information given on this form is confidential and will be processed in line with our privacy policy.

Consent for storing and processing your personal information *

Yes, I give permission to store and process my personal information

Customer Panel Application form