Volunteer Application Form

Please complete all questions in fullusing block capitals.

Personal Details

Title: / First Names: / Surname:
Address:
Date of Birth
Telephone Number: / Mobile:
Email:
NB Please detail any restrictions on daytime calls or email contact
Emergency contact name:
Relationship:
Tel No: / Mobile:

Do you drive?

Yes / No
Work History and Experience (Please use a separate sheet if required).

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Application Information

Which areas of volunteering with Compaid are you most interested in? (Please tick all that apply)

Training Centre Computer Assistant / Driver
Outreach Computer Assistant / Escort
Trustee
Fundraising (Please tick all that apply) / Organising events e.g.quiz nights, coffee morning, cakes/preserves sale
Serving on committee that plans events / Helping at events
Selling Greetings Cards / Selling Raffle Tickets
Street/Store Collections / Taking part in sponsored events, e.g. sponsored run or swim
Other support that you are able to give Compaid: Please give details

Are there any areas you wish to avoid? Yes No

If yes, please give details: ______

Availability

What times are you available to volunteer with us?

Mon / Tues / Weds / Thurs / Fri / Sat / Sun
am / pm / am / pm / am / pm / am / pm / am / pm / am / pm / am / pm

What level of commitment are you able to give:

Weekly / Monthly / Quarterly
1 – 2 Hours / 3 – 4 Hours / 4 + Hours / 1 – 2 Hours / 3 – 4 Hours / 4 + Hours / 1 – 2 Hours / 3 – 4 Hours / 4 + Hours

Would you be available on an Ad Hoc basis if required?YesNo

Please complete the questions below as fully as possible using an additional sheet of paper if required.

Why would you like to volunteer for Compaid?
What do you hope to gain from volunteering with Compaid?
What qualifications, skills or experience do you have which might be applied to this voluntary position?
Health and safety requirements. Please give us details of any medical condition that might require special attention, so that we can take all reasonable care to ensure your safety whilst working as a volunteer. This information will allow us to act quickly and properly in case of an emergency.

References

Please give the name and address of two referees.

Please note – You musthave known each referee for over 12months and they should not be a relative. If you have worked in the past fiveyears, at least one reference should be obtained from your last employer.

First Referee
Name: / Second Referee
Name:
Position: / Position:
Address: / Address:
Email: / Email:
Telephone: / Telephone:
Fax: / Fax:
Relationship to you: / Relationship to you:
If you are not a member of the European Community, do you require a work permit? Please note - individuals need a work permit visa or a student visa to volunteer and cannot do any type of work, including voluntary work, on a visiting visa. /  Yes  No

Data Protection

In accordance with the Data Protection Act 1998, I agree that Compaid may hold and use personal information about me for volunteering reasons and to keep in touch with me. This information, including that contained in this application can be stored on both manual and computer files.

Declarations

Rehabilitation of offenders Act 1974

The Rehabilitation of Offenders’ Act 1974 allows people who have been convicted of certain criminal offences to regard their convictions as ‘spent’ after a period of years.

The people that Compaid works with are defined as vulnerable adults, and any role that brings you into one-to-one contact with them is exempt from the provisions of Section 4(2) of the 1974 Act. Applicants are therefore not entitled to withhold information about convictions that for other purposes are considered as ‘spent’.

Do you have any Criminal Convictions you need to Disclose?
A past conviction will not necessarily prevent you from volunteering. /  Yes  No
If Yes, please give details:

I confirm that the information on this form is correct. I understand that some of the tasks involved in my role with Compaid may be of a sensitive nature and I agree to maintain confidentiality at all times.

Signature: ______Date: ______

Disclosure & Barring Service

Compaid maycarry out a Disclosure & Barring Service (DBS) check on successful applicants.

Do you hold a current DBS certificate issued after 17/06/13
If yes:
Are you registered with the DBS Update service? /  Yes  No
 Yes  No
And
Do you give your consent for Compaid to carry out a status check using the
DBS Update Service /  Yes  No

I understand that I do not have to agree to this records check, but that my refusal may exclude me from consideration for this volunteer position.

Signature: ______Date: ______

For monitoring purposes, please complete the attached Equal Opportunities form and return it to us.

Please send completed forms to: Judith Williams, H R Administrator, Compaid, Unit1 Eastlands, Maidstone Road, Paddock Wood, Kent, TN12 6BU

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