Ipswich Winter Night Shelter - Volunteer Application Form

Before completing this form, please read the following:-

  • A reference must be supplied. It will be checked.
  • All new volunteers must attend the training session before they can be allocated shifts.
    The training will be from 9:30am until 12:30pm (registration from 9:00am) on Saturday 5thNovember.
    A second training session will take place on Wednesday7thDecemberstarting at 7pm for those unable to attend the first session. Volunteers attending this session will not be allocated shifts until after this date.
  • We are very short of volunteers to cover the Morning and particularly the Night shifts.
  • Email is our main method of contacting volunteers, so please supply an email address if at all possible.
  • Acceptance of volunteer applications is at our discretion.

Please (preferred)

OR toIWNS c/o Trinity Bungalow, 20 Back Hamlet, Ipswich IP3 8AJ

If returning by post, please complete this form in blue or black ink and attach extra paper if there is not enough space provided.

About You
Name: / Gender: M/F……..
Email Address OR None: / Postal Address:
Phone Numbers
Home: / Work: / Mobile:
Place of Worship OR None
Age group (please circle or mark) / 20s 30s 40s 50s 60s 70+ (If under give date of birth: ……………..)
Do you have any disability we should be aware of:
Any Allergies:
Your Availability and Role
Shelter / Evening 6.00pm–10.15pm / Night 10.00pm– 7.00am / Morning 6.45am – 9.00am
Please tick (or mark) which shifts you would like to volunteer for. / Any
OR / Any
OR / Any
OR
Holy Trinity. / Mon  / Mon  / Tue 
St Mary’s Stoke / Tue  / Tue  / Wed 
Ipswich Community Church / Wed  / Wed  / Thu 
Christ Church-St Pancras / Thu  / Thu  / Fri 
Burlington / Fri  / Fri  / Sat 
St. Margaret’s / Sat  / Sat  / Sun 
Hope Church / Sun  / Sun  / Mon 
Also indicate the number of shifts per week or per month for which you wish to volunteer. / Number
……………… / Per Week/Month
(Delete as appropriate).
Please enter notes about anything else which will affect your availability.
Can you attend the training sessions?
9:30am-12:30pm Sat 5th November 2016. Registration from 9:00am.
OR 7pm – 9:30pm Wednesday 7th December 2015.
Do you have a current food hygiene qualification? / Date:
Do you have a current DBS check for working with vulnerable adults? / Date:
Do you have any previous convictions? / Details and dates:
Have you any specific skills/talents that you can offer such as Cooking, First-Aid, Prayer, Fundraising, Administration and co-ordination?
Are you TEFL trained or do you speak any additional languages? – If so please give details:
Please give details of any previous or current experience which may be relevant, particularly relating to substance abuse, mental health, learning disability or other associated issues.
Emergency Contact
Name:
Address: / Relationship to you:
Phone Numbers
Home: / Work: / Mobile:
Reference (This should be someone who has known you for at least two years in a professional capacity, e.g. Church Leader or Line Manager)
Name:
Address: / Email Address:
Telephone number:
Relationship to you:

Signed: ………………………………………….. Date: ………………………

(If you are returning this form electronically you may sign at a later date)

Thank you for completing this form.