Fieldworker/research registration form

Please complete this form, providing as much information as possible. Your details will be added to our fieldworker/researcher database, however, there is no guarantee that there will be work.

Name
Address
Postcode
Tel no. / Mobile No.
E-mail

Areas of expertise/experience/services provided

Please tick which services you can provide

Qualitative research / Quantitative research
Recruitment – face to face / Mystery shopper
Recruitment - telephone / In-home quota interviews
Hostessing / In-street quota interviews
Moderating groups / Telephone interviews
Interviewing/moderation / CAPI (computers assisted)
Quality checking
Data processing
Hall Tests
Other? / Other?
Are you ICQS trained? / Yes / No
ICQS Number:
Do you have any other accreditation? PLEASE LIST
Are you a supervisor? If yes, please provide details of how many fieldworkers you supervise, where etc.
Please list the languages you speak and read to a native speaker standard
Do you have a full clean driving licence allowing you to drive in the UK? / Yes / No
Do you have use of a vehicle to carry out work for Enventure? / Yes / No
Are you available to travel away from home and if required stay overnight? / Yes / No
The interviewing assignments require a high level of mobility, will this cause you any problems? / Yes / No

Availability to work – please tick boxes below

Day / Evening
Monday – Friday / Total number of hours available per week
Saturday
Sunday

Which areas can you work in?

Yorkshire & Humber / West Midlands
North East / South East
North West / South West
Scotland / London
Wales / Anglia
East Midlands

Please provide further clarification if required.

Experience

Please provide details of past market research experience/projects you’ve worked on in last 2 years

Date / Company/organisation / Details of research/fieldwork

References – please provide two references below

A reference MUST be able to be obtained by Enventure confirming market research interviewing experience was gained within the last 12 months

Name
Company/organisation
Address/Email/Tel. no
Details of work carried out
Name
Company/organisation
Address/Email/Tel. no
Details of work carried out
Are you legally entitled to work in the United Kingdom? / Yes / No
If your application is successful we will ask you to provide documentary evidence of your entitlement to work in the UK
Do you have any ‘unspent’ criminal convictions under the Rehabilitation of Offenders Act 1974? / Yes / No
If YES please give details:

Any other information

Please provide any further relevant information

Declaration

I confirm that above information is correct and understand my details will be kept on file and if/when suitable work arise, will be contacted by Enventure.

Signed………………………………………………………………….

An electronic signature will be acceptable

Date……………………………………………………………………..

Once completed, please email to

Or post to

Enventure Research

Bradford Chamber Business Park

New Lane

Laisterdyke

Bradford

BD4 8BX