LaganValley Rural Transport

The Courtyard

Larchfield Estate

Bailiesmills Road

Lisburn

BT27 6XJ

Tel: 028 9263 9994

VOLUNTEER APPLICATION FORM

All information given will be treated in the strictest confidence and will be used to try to match potential volunteers to the most appropriate roles available with Lagan Valley Rural Transport at the time of application.

APPLICATION REF:

Name
Address
Postcode / Date of Birth / /
Tel. (Home) / Tel. (Work)
May we contact you at work? / Yes / No
Tel. (Mobile)
Email Address
Are you (Please tick)
Employed / Unemployed / Retired
Student / Housewife / Disabled
Other (specify)
Please indicate the volunteer role(s) you would be interested in:
Driver / Administration / Promotions
When would you be able to volunteer with us? (Please tick)
Mon / Tues / Wed / Thur / Fri / Sat / Sun
Morning
Afternoon
Evening
Please outline previous work experience (include ACE / JTP / YTP / etc.):
Please outline previous voluntary work experience, if any:
What motivated you to apply for a volunteer role with Lagan Valley Rural Transport?
What skills, knowledge or experience do you feel you could bring to a voluntary role with Lagan Valley Rural Transport?
Please outline any spare time hobbies, interests or activities:
LaganValley Rural Transport aims to be an inclusive and supportive organisation. In accordance with the Disability Discrimination Act 1995, a person is considered to have a disability if s/he has ‘a physical or mental impairment which has a substantial and long term adverse effect on a person’s ability to carry out normal day to day activities.’ Please note it is the effect of the impairment, without treatment, which determines if an individual meets this definition of disability.
Do you consider that you meet this definition of disability?
Yes / No
Are there any reasonable adjustments we could make as part of your recruitment process which would enable you to enjoy equality of opportunity in getting a volunteer role with us?
Please provide the names and addresses of two people who have consented to provide a reference on your behalf (Referees must not be related to you and should have known you for at least 2 years within the last 5).
Name / Name
Address / Address
Postcode / Postcode
Tel. (Home) / Tel. (Home)
Tel. (Work) / Tel. (Work)

Signature:______

Print Name:______

Date:______

Please return completed forms to:Lagan Valley Rural Transport

The Courtyard

Larchfield Estate

Bailiesmills Road

Lisburn

BT27 6XJ

Tel:028 9263 9994

Fax:028 9263 9888

PLEASE NOTE:Due to the nature of our work, all successful applications will be

subject to Enhanced Access NI clearance.

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