Swindon Women’s Aid
VOLUNTEER PLACEMENT APPLIED FOR:
Proposed start date:
PERSONAL DETAILS
Full Name / Tick box Miss Mrs Ms
Address / Telephone
Home
Best time to call:
Mobile
Postcode / Email
Provide details of your skills and work experience along with any educational/professional qualifications gained.
Please explain your understanding of confidentiality:
Hobbies & Interests:
CRB Check
Do you have a current CRB certificate? (we will also need to do our own check)
Yes No Date
Driving
Do you hold a valid, full driving licence? Yes No
Does your licence have any endorsements? Yes No
If Yes, what for and how many?
How long have you held a full licence?
Convictions
In order to protect the public, anyapplication made with Swindon Women’s Aid is exempt from Section 4 (2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 as amended by the Rehabilitation of Offenders Act 1974 (Exceptions) (Amendment) Order 1986. You must therefore disclose any criminal convictions, cautions, reprimands or warnings you may have, even those which would otherwise be considered as 'spent'.
In the interests of protecting children, any applicants selected for employment, volunteering or placement will be required to give their permission for the Organisation to carry out a check with the Criminal Records Bureau to establish whether or not they have a criminal background. Any information gained will be handled and stored appropriately.
If you fail to disclose any convictions, cautions or bind overs could result in dismissal or disciplinary action by the Organisation.
Have you ever been convicted of a criminal offence? Yes No
If Yes please provide details:
Date / Nature of Offence / Sentence or verdict of Court
References
Please provide full contact details of two references, one of which must be your current employer or educational establishment, or if not currently employed, your most recent employer/manager (not a colleague). References will only be taken up for successful candidates. All offers of employment are conditional and subject to references satisfactory to Swindon Women’s Aid and pre-employment checks, including Enhanced Criminal Records Bureau disclosure where required.
Please do not use friends or relatives.
Name: / Name:
Address: / Address:
Tel No: / Tel No:
Email: / Email:
Relationship: / Relationship:
Do you need any adjustments to enable you to undertake this role?
DEMONSTRATION OF YOUR SUITABILITY FOR THE ROLE
Please indicate briefly why you are applying for this role and indicate why it appeals to you. Additionally please describe your current or most recent experience, skills and qualities which you feel are relevant.
This application, when completed, should be sent to:
Applications
Swindon Women’s Aid
PO BOX 3816
Swindon
SN5 1BQ
alternatively, please email it to: