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Emergency Host Application

Step 1 of 11 - Your Personal Details

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  • Your Personal Details

    Please note that the contact details you enter in this section will be considered the details of the “lead contact” and all correspondence and updates will be provided via their contact information.
  • DD slash MM slash YYYY
  • If you don't complete the information for other adults here it can cause a delay in the application process. Checking "yes" will open more questions for us to gather the information.
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  • Second Contacts Personal Details

    Please note that the contact details you enter in this section will be considered the details of the “second contact”. There will be no correspondence or updates sent to them.
  • DD slash MM slash YYYY
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  • Please provide the details of any other adults in your home.

  • Full NameDate of Birth (dd/mm/yyyy)RelationshipContact Number (If applicable)
  • Full NameDate of Birth (dd/mm/yyyy)RelationshipContact Number (If applicable)
  • Full NameDate of Birth (dd/mm/yyyy)RelationshipContact Number (If applicable)
  • Full NameDate of Birth (dd/mm/yyyy)RelationshipContact Number (If applicable)
  • Full NameDate of Birth (dd/mm/yyyy)RelationshipContact Number (If applicable)
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  • References

    For anyone applying to be a host, we need to have two references for each person. The references for each person. The referees can be people who just know one of you, or they might know both of you. Please make sure that they have agreed to act as your referee. We request one personal reference and one professional reference. We advise you to choose referees who know you well and, where possible, have an understanding and knowledge of your household. They need to be able to answer the questions fully and so they need to have known you for at least a year. If you would like to see the reference form, please contact who can forward you a copy before requests are made. Gloucestershire Nightstop values your support and promises to respect your privacy. The data we gather and hold is managed in accordance with The Data Protection Act 2018 and the General Data Protection Regulation (GDPR). We will not disclose or share personal information without your consent.
  • Personal Referee

    The personal referee should know both applicants, if applicable, Please contact if you need to provide a further personal referee for contact 2.
  • Professional Referee for Lead Contact

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  • Professional Referee for Second Contact

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  • Disclosure and Barring Service

    Because of the nature of Gloucestershire Nightstop work, many of our posts are exempt from section 4 (2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. Applicants are therefore obliged to provide details of the criminal record, including spent convictions, at an early stage of the application process. Please note that failure to reveal information that is directly relevant to the position may lead to withdrawal of the offer of appointment or subsequent dismissal at a later date. Any information given will be confidential and will only be considered in relation to an application for a position to which the order applies. We would like to stress that having a conviction will not necessarily prevent you from gaining a position with us. Any information given will be confidential and will only be considered in relation to an application for a position to which the order applies. We would like to stress that having a conviction will not necessarily prevent you from gaining a position with us.
  • DD slash MM slash YYYY
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  • DBS certificate number starting "00" not Update service reference number
  • DD slash MM slash YYYY
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  • Your Doctor's Contact Details

    All the information you have provided is to request a health check from your doctor, for all adults in the household, as part of the health and safety risk assessment. Please provide your doctor's name and address details.
  • Doctor/Surgery NameDoctor/Surgery AddressDoctor/Surgery Contact Number 
    | list add | list remove
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  • By signing in the box below, I confirm that I wish to become a Gloucestershire Nightstop host and that all information provided on this application form is true.

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  • Host Equality, Diversity and Inclusion Monitoring Form

    Gloucestershire Nightstop is committed to attracting host applications from all sectors of the community. We invite you to help us monitor how well we are doing in this regard. We strive to provide a working environment in which everyone feels valued, respected and able to contribute. We would be grateful if you took the time to complete and return this questionnaire. This is an entirely optional form – you can complete as much or as little of the form as you feel comfortable with. The information you provide will be treated in strict confidence and will not be used as part of the selection process. By completing and returning the monitoring form which follows, you consent to Gloucestershire Nightstop processing this information for general monitoring purposes in line with the Equality, Diversity & Inclusion and the Data Protection & Confidentiality policies. If your application to become a Supported Lodgings provider is accepted, the information will be kept and used for regular internal monitoring of the diversity of the Gloucestershire Nightstop host profile.
  • If you become a volunteer for us, we would like to send you our newsletter and invitations to events. Please tick one of the following.
  • This field is for validation purposes and should be left unchanged.
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Contact us

13 Ladybellegate Street,
Gloucester
GL1 2HN

Phone: 01452 331330
Email:

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Registered charity number: 1102988

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