Ocean Youth Trust South

A company limited by guarantee no.3898084 Registered charity no.1079959

VOLUNTEERSEA STAFF APPLICATION / REGISTRATION

Please complete in block capitals and black pen

Forename(s) ______Surname Mr / Mrs / Ms / / ______

Preferred forename to be used ______(if different from above)

Address ______

Town______County / Region ______

Postcode ______Telno. DAY ______

EVENING ______MOBILE ______

Email ______

Date of birth ______Age ______Male / Female

Your occupation ______

Please supply names of two referees who have known you for at least three years. These should if possible include an employer; another charity for whom you have volunteered; or a person of some standing in the community, such as a magistrate, minister of religion, a professionally qualified person such as a doctor, lawyer, engineer, teacher, civil servant or a police officer. OYT South will approach your referees for further information about you.

REFEREE 1

Name ______

Address ______

______Postcode ______

Tel no. ______Email______

Occupation ______

REFEREE 2

Name ______

Address ______

______Postcode ______

Tel no. ______Email______

Occupation ______

SAILING: Qualifications & Experience

Do you possess any of the following?

Delete as applicable / Certificate no. / Date awarded
RYA/MCA Yachtmaster Ocean / yes / no
RYA/MCA Yachtmaster Offshore / yes / no
RYA/MCA Yachtmaster Coastal / yes / no
RYA Day Skipper / yes / no / n/a
RYA Competent Crew / yes / no / n/a
Endorsements to Certificate / Expiry Date
Commercial use on vessels subject to codes of practice
Instructor
Examiner
Delete as applicable / Date completed / Name of course and
awarding body
First Aid at Sea or other First Aid / yes / no
Proficiency in Medical Care Aboard Ship / yes / no / n/a
Food hygiene / yes / no
Short Range Certificate (VHF only) / yes / no / n/a
General Operators Certificate(GMDSS) / yes / no / n/a
Restricted Radio Operators (SSB) / yes / no / n/a
Basic Sea Survival Certificate / yes / no / n/a
RYA Diesel Engine Course / yes / no / n/a
RYA Radar Course / yes / no / n/a
Powerboat Level 2 / yes / no / n/a

Please list any other relevant sea-going qualifications:

SYNOPSIS OF SAILING EXPERIENCE

(NB those with extensive sailing experience can give a few examples, especially if this includes time in

vessels over 60 feet LOA; but include logged or estimated TOTAL sailing experience in the bottom row)

Vessel name / Vessel length overall or tonnage / Capacity in which sailing (e.g. skipper, mate of watch, crew) / Days on board / Distance logged / Night hours

YOUTH WORK / OUTDOOR EDUCATION: Qualification & Experience

Name of Organisation / Duties & Responsibilities / Dates

Do you possess a Safeguarding qualification, or have you completed any Child Protection training? Yes/No
Was this completed within the last three years? Yes/No

Name of course / qualification______

Name of awarding body______

Date of course completion______

Please send a copy of any certificates to the OYT South office with this application.

Newsletter

Every week we send out a newsletter by email (also known as the bulletin) describing what exciting things we are up to, sailing vacancies, training courses and other vital information for sea staff and volunteers. If you don’t receive this you will miss out on hearing key information about OYT South including when and how to book for voyages. It is essential that we send this to you if you wish to be actively involved; but we cannot send it without your consent.

I consent to receiving by email OYT South’s weekly newsletter by email

Please attach a passport type photograph (or similar) of yourself.

Or alternatively you can email a photograph to

DECLARATION

  1. We care about your privacy and want you to be confident in the way we use your personal information - which is why we’ve put together the short summary so that you can get the facts at a glance.
  2. The use and retention of your personal information is set out in our Privacy Notice for Volunteers and more detail can be found in our Privacy Policy have read these documents and I understand how OYT South will process my personal data and the options available to me.
  3. In order to recruit to this post OYT South will process personal information given in connection with this application. Information relating to the successful applicant will form part of personnel records. I consent to the processing of personal information in the way described.
  4. I declare that to the best of my knowledge the information given on this form is correct and understand that misleading statements or deliberate omission may be sufficient grounds for cancelling any appointment arising from this application.

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

Please return completed form to: Ocean Youth Trust South, Unit 8 North Meadow,

Weevil Lane, Gosport, Hampshire, PO12 1BP

Tel. 023 9260 2278 Fax. 023 9252 5829 Email

With copies of any certificates listed on this form.

11.05.18