Volunteer Application Form
About you
First Name
Surname
Male / Female
Address
Postcode
Home / Work
Mobile / Fax
Email address
School/College
[If appropriate]
Type of volunteer role you wish to apply for (please tick relevant box)
Library Club / Baby Bounce & Rhyme / Summer Reading Challenge / Story time / Supernova Buddy / Make Friends with a Book
Computer Buddy / Housebound Delivery / Family & Local History Support / Library Support Volunteer / Homework Support / Other
Please list libraries you are willing to volunteer at below
Paid and voluntary work experience
Date / Organisation and role
From
To
From
To
From
To
Relevant skills, qualifications and experiences
Qualifications
Skills e.g. computer skills/IT
Experience e.g. people skills, working with children/elderly
Reference: Please give the name of someone who can be contacted for a reference.
This person should not be related to you.
Name
Address
Postcode
Telephone No
Please detail below how you heard about volunteering in Gloucestershire Libraries
And finally….
No one is excluded from volunteering but for some activities with children and/or vulnerablepeople volunteers may be screened (CRB check). This is a legal requirement.
You will be contacted shortly to arrange a convenient time for interview
GCC holds personal information on a database and treats it with respect.
Please sign below and return to:
Signature: / Date:
Parent/Guardian if under 16:

------

Equal Opportunities Monitoring Form

Gloucestershire County Council Library Volunteers

GCC is committed to equal opportunities and welcomes all applicants. To help us, please answer these questions by putting a tick in the appropriate box. This information will only be used for monitoring purposes and it will be treated as strictly confidential. It will be separated from the application form on receipt and will not in any way influence your volunteering.

Name:
1. Are you: / 2. Do you have a disability?
 / Female /  / Yes
 / Male /  / No
3. How old are you?
 / Under 16 /  / 41 - 50
 / 16 - 24 /  / 51 – 60
 / 25 - 30 /  / 60 and over
 / 31 - 40
4. What is your ethnic group? Choose ONE section, then tick the appropriate box to indicate your cultural background.
White / Black or Black British
 / British /  / Caribbean
 / Irish /  / African
 / Any other white background.
Please specify: /  / Any other Black background.
Please specify:
Asian or Asian British / Mixed
 / Indian /  / White and Black Caribbean
 / Pakistani /  / White and Black African
 / Bangladeshi /  / White and Asian
 / Any other Asian background.
Please specify: /  / Any other Mixed background.
Please specify:
Chinese or other ethnic group
 / Chinese /  / Any other. Please specify:
5. How did you find out about volunteer opportunities at GCC libraries? Please select the MAIN way you found out about volunteering for the library
 / Newspaper article /  / Radio
 / Information in library /  / Recommended by a friend
 / Recommended by library /  / Community group
 / Volunteer Centre /  / Other (please specify)
Consent Form for Photographs/Video/Audio

I agree that images of me (or the child I have legal responsibility for) may be used by GCC, or organisations working on their behalf, for promoting or raising funds for GCC and its programmes.

I agree that GCC has full editorial rights over photos taken and may make fullest use of them throughout the world in perpetuity by any and all means, and in any and all media.

I understand my right to ask to see any information held about me by GCC.

Name of person in photo(s)/ audio/ video(s)*
Name *
(a parent/ guardian must complete this section if the beneficiary is under 16 years
of age)
Signature * /
Date *
Address
Phone / E-mail

(* = essential information)

January 2012