Emmanuel House Volunteer Application Form

Emmanuel House Volunteer Application Form

Your details

Name:

Address:

Post Code:

Telephone number:

Mobile:

Email:

Date of birth:

My gender is;

/

Female / Male

Details of someone we can contact on your behalf in the case of an emergency

Name:

Address:

Telephone number:

Mobile: /

Post code:

I confirm that I am 18 years of age or over / Yes / No

There are a number of different volunteer roles. Please indicate which roles you are interested in.

Kitchen Mon, Tue, Thurs, Fri 9.00am-1.45pm. Sundays 11.00am – 2.00pm / Allotment (Tues & Sun AM) / Activities
Saturday evening6.15pm-9.15pm / Listening and Befriending (not Wed) / Charity Shop
Wednesday breakfast
(9.00am – 10.45am) / Sundays
(11.30am – 3.00pm Starts 5th July 15) / Reception
Administration/Marketing/data
in-putting. (We will discuss the options with you) / I am unsure and would like to speak to someone about what I could do. / Wednesday evening 6.16pm-9.15pm
(Provided by Nottingham Christian Centre)
Please give details of other skills / experience / training / qualifications which you can bring to Emmanuel House.
Do you have any special needs / requirements/ health problem, or support needs that you feel we should know about?
Are you currently accessing support for certain areas of your life? YES/NO
(If ‘yes’ please give details)
What is your current employment status?
(i.e. full-time, retired, student, unemployed)
What do you want to get out of volunteering at Emmanuel House?
Where did you hear about volunteering at Emmanuel House?
Declaration
Because of the nature of the work, involving contact with vulnerable people, you are required by the Rehabilitation of Offenders Act 1974 to declare all criminal convictions including those that are spent.
Have you ever been convicted of a criminal offence? / Yes / No
If ‘yes’ please give details
I confirm that the information I have provided is accurate to the best of my knowledge.
Print name:
Signature:
(if the form is emailed it can be signed when visiting Emmanuel House )
Date:

Please do not return your application form without sending the reference pack to two referees.

Please find us on Facebook

and click on the Sign Up’ button. You and also note our website which is

EMMANUEL HOUSE VOLUNTEER RECRUITMENT MONITORING

This part of application form will NOT be used in any recruitment process.

Emmanuel House are committed to the development of positive policies to promote equal opportunities in employment and in the delivery of our services, regardless of race, disability, gender, belief or religion, age, pregnancy and maternity, gender reassignment, marriage and civil partnership or sexual orientation. One aim of this policy is to make sure that you and other applicants are not discriminated against. The policy also aims to make sure that you are not disadvantaged by job conditions or requirements that are not relevant.

Please tick as appropriate:

Your gender – are you: / Male
/ Female
/ Transsexual/Transgender

Your age: / 16-25
/ 26-35
/ 36-45
/ 46-55
/ 56 and over

I would describe my ethnic origin as:

(please note this question does not refer to your nationality / country of origin)

White: / Black or Black British:
English / African
Other British / Caribbean
Irish / Other Black Background (please describe)
Other White Background (please describe)
Asian or Asian British: / Mixed (dual heritage):
Indian / Asian and White
Pakistani / Black African and White
Bangladeshi / Black Caribbean and White
Chinese / Other Mixed Background (please describe)
Other Asian Background (please describe)
Other Ethnic Group:
Arab
Gypsy
Irish Traveller
Romany
Other Ethnic Background (please describe)

What is your religion or belief?

No religion/belief
/ Christian
/ Buddhist
/ Hindu
/ Jewish
/ Muslim
/ Sikh
Other Religion (please describe): / ______
Other Belief (please describe): / ______

What is your sexual orientation?

Heterosexual
/ Bisexual
/ Gay Man
/ Lesbian

If you consider yourself to be disabled, please specify:

Communication
Mobility / Hearing
Physical / Learning
Visual / Mental Health
Other
Please give further details, if you wish: ______

How did you find out about this vacancy?

Emmanuel House
Facility Community
Job Fair
JobCentre Plus
Local Press (please specify)
National Press (please specify)
NCC Website
Newsletter
Other (please specify)
Website (please specify)
Word of Mouth

Please return the form to: and put ‘Application for Emmanuel House’ in the subject box or a hard copy to:

Denis Tully

Volunteer Programme Coordinator,

Emmanuel House, 53-61 Goosegate,

Nottingham NG1 1FE Thank you

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