APPLICATION FOR VOLUNTEERINGAT KALEIDOSCOPE

Forename(s) ______

Surname ______(Mr/Mrs/Miss/Ms)

Address ______

______

______Postcode ______

Telephone (home) ______(daytime) ______

Email ______

At Kaleidoscope we value all of our volunteers; in fact many of our staff began their career as a volunteer. We don’t require you to have previous experience of working within the Drug and Alcohol field to volunteer with us, nor do you need to have previous experience as a volunteer. We value passion and enthusiasm as highly as experience.

Our volunteer placements are very popular and we receive a high number of applications each time we recruit. Unfortunately we only have a limited number of opportunities and have to shortlist applications for interview. This application form is your opportunity to tell us what you can bring to the organisation and why you think we should choose you. We are looking to find out your interests, your reasons for wishing to volunteer with us and your skills and attributes. If successful, this information also helps us to make sure your volunteering experience is as relevant to your needs as we can offer.

Please be aware that due to the nature of our work, all volunteer and work placements within Kaleidoscope are subject to satisfactory outcomes resulting from anDisclosure and Barring System (DBS) check and, possibly, a reference check.

I Personal

1. Do you have a full driving licence?YES/NO

2. Do you have access to a car?YES/NO

3. Have you ever been convicted of a criminal offence? YES/NO

II Experience

1. Please list any qualifications / training that you feel may be relevant to volunteering:

Course title / From/to / Course provider / Summary of content

Volunteering Experience:

Agency name and
Address / From
/to / Brief descriptions of duties / Reason for
Leaving

NB: Please be aware we may contact previous organisations in respect to your experience.

If you do not wish for us to do this, please tick here

  1. Please let us know of your hobbies and interests:
  1. Current Employment Status (please highlight or circle):

Employed Full-time / Employed Part-time / Unemployed / Student

Employment History:

Employers name and
Address / From
/to / Position held and brief descriptions of duties / Reason for
Leaving

NB: Please be aware we may contact previous organisations in respect to your experience.

If you do not wish for us to do this, please tick here

III Projects

  1. Please tell us why you are interested in volunteering in the substance misuse field and what you would like to gain from volunteering with Kaleidoscope:
  1. Please describe the skills, knowledge, experience and values that you possess that you feel would enable you to be a good volunteer
  1. In order of preference, (1 being your most preferred), in which of the following locations would you be prepared to volunteer? If you are unable to volunteer in any of the locations, please leave the preference box blank.

Location / Preference / Location / Preference
Blaenau Gwent / Monmouthshire
Bridgend / Neath Port Talbot
Caerphilly / Newport
Cardiff / Pembrokeshire
Carmarthenshire / Torfaen
Ceredigion / Kingston upon Thames
  1. Please rank, in order of preference (1 being your first choice), the following Kaleidoscope projects that you are interested in and state why?

Project / Activity / Preference / Reason
Diversionary Activities
Drop In
Training and awareness
Raising
Adult Service User Support
Administration

EQUAL OPPORTUNTIES MONITORING INFORMATION PROFORMA

STRICTLY CONFIDENTIAL

Please complete and return with your completed application form. You may choose not to provide certain information and this will not affect the selection process.

In accordance with Kaleidoscope’s Equal Opportunities Policy and Recruitment and Selection Policy, Kaleidoscope will select new employees on job-related criteria, as outlined in the person specification. Kaleidoscope welcomes staff diversity and is an equal opportunities employer. We aim toensure that no job applicant or employee will receive less favourable treatment on the grounds of sex, marital status, gender reassignment, race, colour, nationality, ethnic origin, disability, religion or belief, political belief, sexual orientation, pregnancy or childbirth, membership of a trade union, part time working or age.

The information you give on this form will be held for monitoring purposes only; it will be detached from the application form and will not be available to line managers, link workers or anyone involved in the short-listing or selection process.

Name:
Opportunity applied for:
Age:
Please give your age range by ticking the appropriate box:
 16-25 /  26-35 /  36-45 /  46-55 /  over 56 /  Rather not disclose
Gender:
Please specify:
Sexual Orientation:
Please describe your sexual orientation by ticking the appropriate box:
 Heterosexual / Straight /  Gay Man /  Gay Woman / Lesbian
 Bisexual /  Rather not disclose
Nationality:
Ethnic Origin:
Please describe your ethnic origin by ticking the appropriate box:
White
 English /  Scottish
 Welsh /  Irish
 Any other white (please specify):
Mixed
 White and Black Caribbean /  White and Black African
 White and Indian /  White and Chinese
 Any other mixed (please specify):
Asian
 Indian /  Pakistani
 Bangladeshi /  Chinese
 Other (please specify):
Black
 African /  Caribbean
 Any other Black (please specify):
Other
 Other (Please specify):
 Rather not disclose
Have you ever sought, or are you currently seeking, help for a substance misuse problem? /  Yes /  No
If yes, please describe what, how long ago and any ongoing issues/prescription:
Do you have a disability as defined under the Disability Discrimination Act 1995?
That is: Do you consider yourself to be someone who has a physical or mental impairment which has a substantial and long term effect on your ability to carry out normal day to day activities?
 Yes /  No /  Rather not disclose
If yes, please describe the nature of your disability:
Please detail below any reasonable adjustments we need to consider, due to a disability, if you are invited to interview for a volunteering place.
For example access to interview rooms, alternative equipment, etc.
How did you hear about this volunteering opportunity?
Please tick the appropriate box:
 Kaleidoscope Website /  Kaleidoscope Internal Advert
 Friend, Relative, Colleague /  College / Place of Education
 RecruitPlus /  KaleidoscopeStaff Member / Volunteer
 Other Voluntary organisation (please specify):
 Other (please specify):
How are you submitting your application?
Please tick the appropriate box:
 By Post /  ByEmail /  In Person /  Via RecruitPlus

THANK YOU FOR COMPLETING THIS FORM

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KaleidoscopeVolunteer Application Form October 2015