This form is for staff who have been working within the vaccination programme to transition to the Workforce Bureau Bank. It is relevant to both clinical and non clinical staff. Existing vaccinator staff joining the Workforce Bureau Name* First name Last name Email* Employee numberIf you do not know your employee number, you can leave this blank.Your role*Please pick from listVaccinatorClinical SupervisorAdministratorFront of House ReceptionHealthcare AssistantWhen can you work? please select as many as applicable.*To help us understand how many people we have available when to support the vaccination of the upcoming patient cohorts, we would really appreciate it if you could tell us when you are available for work. We won't hold you to this, it's to give us a general indication of when you are available. These shifts match the shifts our vaccination centres generally request. You can working one, two or three 4 hour shifts on a given day, depending what the site has available and requires. Select All Monday 08.00 - 12.00 Monday 12.00 – 16.00 Monday 16.00 – 20.00 Tuesday 08.00 - 12.00 Tuesday 12.00 – 16.00 Tuesday 16.00 – 20.00 Wednesday 08.00 - 12.00 Wednesday 12.00 – 16.00 Wednesday 16.00 – 20.00 Thursday 08.00 - 12.00 Thursday 12.00 – 16.00 Thursday 16.00 – 20.00 Friday 08.00 - 12.00 Friday 12.00 – 16.00 Friday 16.00 – 20.00 Saturday 08.00 - 12.00 Saturday 12.00 – 16.00 Saturday 16.00 – 20.00 Sunday 08.00 - 12.00 Sunday 12.00 – 16.00 Sunday 16.00 – 20.00 How many hours a week can you commit to?*Which Sites can you work at- please tick all that apply* Select All Peepul Centre Leicester City Loughborough Hospital Fielding Palmer Hospital Coalville Charnwood Borough Council Offices Rutland County Council Offices Melton Sports Village The Kube / Leicester Racecourse Measham Leisure Centre Hinckley Leisure Centre Prajapati Centre Heath Lane, Earl Shilton Merridale Medical Centre Harborough Leisure Centre Community Health Centre Sturdee Road Practice St Peters Health Centre Fosse Medical Centre Market Harborough Medical Centre Westcotes Health Centre Thorpe Astley Surgery Humberstone Medical Centre This is to help us understand where we have coverage. You will still be offered all relevant shifts to the work you want to do, ticking or not ticking a site will not restrict you from being offered work there. In addition the Workforce Bureau supports various PCN sites around Leicester, Leicestershire and Rutland. By joining the Bureau you will also be able to access opportunities with them- that doesn't mean you have to work with them, so if you prefer just to work at LPT sites, just book in shifts at those sites. Declaration*I understand the below declaration and am happy to proceedI understand by joining the Workforce Bureau I will be given an additional bank post with the same pay frequency as my substantive/any other bank posts I hold. This will enable me to continue to see shifts with LPT sites and also where PCN's have relevant shifts, those also. Bank posts will be set up at National Workforce Bureau bandings, i.e. Vaccinators will be set up at band 5, Administration roles at band 3, Front of House reception at band 2.