Name

Address

Telephone Number

Mobile Number

Email Address

Are You 18 or Over?

Yes No

Date Of Birth

Preferred Method of Contact

Phone Email

What Days Are You Available

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

What Hours Are You Available

10 am - 1 pm 1 pm - 3 pm 3 pm - 5 pm 5 pm - 7 pm 7 pm - 9 pm 9 am - 11 am (Saturday & Sunday) 11 am - 1 pm (Saturday & Sunday) 6 pm - 9 pm (Saturday Only)

Are You Prepared to Do Extra Shows to Cover Holidays Etc?

Yes No

Are You Prepared to Attend Fundraising Events and Outside Broadcasts?

Yes No

* Required

Online Application Form

Please only fill in this form if you have contacted Ayr Hospital Radio and been instructed to complete an Application Form. Your details will not be shared outwith our organisation.