St Albans Bereavement Network : Volunteer Application Form
ST ALBANS AND DISTRICT BEREAVEMENT NETWORK
VOLUNTEER & STAFF APPLICATION FORM
For more information about volunteering please read our Bereavement MattersInformation Pack for Volunteers. Please send your CV and any other relevant informationwith your completed application.
A copy of our Code of Practice will be provided to all volunteers when they begin working with us.
Section 1Your personal details
Surname: ...... First or given name: ......
Address: ......
...... Postcode: ......
Telephone: ...... Mobile number: ......
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Preferred telephone contact times, if any: ......
E-mail address: ...... @ ......
Where did you hear about the Network? ......
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Reason for applying 200-300 words: ………………………………………………………………………..……..
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Do you need any special arrangements to be made if you are invited for interview:
No
Yes, please give details……………………………………………………………………………………….
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Section 2Your qualifications and experiencePlease provide details of any relevant qualifications or experience in counselling, therapy, working with vulnerable adults or children, other volunteering you have done, etc. Don't worry if you don't have direct experience or qualifications - you may still apply! Please continue on a separate sheet if necessary and attach it to the application form.
- Qualifications -
Date / Place / Title
- Experience - please state any relevant experience you may have
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Relevant courses attended - provide course(s) name and where & when you attended them
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- Skills/Strengths -please provide details
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Section 3What you would like to do for us?
I am interested in (please tick all that apply):
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Counselling – Adults
(qualified or 1st year diploma)
Counselling – Children
(qualified or 2ndyear diploma)
Children’s Work
Visiting & Buddy Service
Clinical Supervision
Reception, Helpline & Administration
Fundraising
Technology Support
Trustee
Other
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Section 4Your referees
Please state here the name, address and (if possible) telephone number of TWO people (not related to you) from whom we can obtain character and work references:
First referee-Current or Last Employer
Full Name: ......
Address: ......
...... Postcode: ......
Telephone: ...... Mobile number: ......
E-mail address: ...... @ ......
Second referee - Personal
Full name…………......
Address: ......
...... Postcode: ......
Telephone: ...... Mobile number: ......
E-mail address: ...... @ ......
Section 5Please read, sign and date the declaration belowI apply to become a volunteer, sub-contractor, or member of staff with St Albans and District Bereavement Network. I understand that the organisation will need to obtain references on me, and may (if applicable) make other enquiries about me before offering me a role.
I also undertake to disclose any information regarding any outstanding complaints with regard to previous positions held, employment tribunal or in relation to other business interests.
I agree that the organisation will need to completeDisclosure and Barring Service (DBS) clearance to confirm that I have no criminal record.
I agree to my personal data being held on the organisation’s computer and paper files held at the organisation’s office for the use of the organisation only. In accordance with the Data Protection Act 1998, all information is securely held by the organisation and will be treated confidentially and with respect. It will be held solely for the purpose of providing support for bereaved persons. The information will not be disclosed to external agents without the express permission of the individual concerned, other than to comply with statutory or other legal requirements.
In order to ensure that information that we hold on you is accurate and up-to-date you should inform the organisation of any changes. Information may be used for the organisation’s own promotional purposes which include our newsletter, information on our activities and fundraising. This may be done by telephone, email or post. If you do not wish your information to be used in this way, or you do not wish to be contacted by electronic means, please inform us.
If appointed as a volunteer, sub-contractor or member of staff forSt Albans and District Bereavement Network:
- I confirm that I will at all times uphold the organisation’s working practices, Code of Practiceand Confidentiality Agreement expectations (a copy of the Bereavement Matters Code of Practice will be provided when you begin working).
- I also confirm that I will fully comply with all other policies, procedures and Health & Safety practices.
I confirm that all the details I have entered on this form are true and complete.
Signed: ......
Print name in block capitals: ...... Date: …………………………….
- Once appointed you will need to complete a role appropriate Induction before you start work.
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