Volunteer Application Form England
Last updated: 15th December 2015
Document owner: Volunteering Development Team
Volunteer Application FormEngland
Thank you for your interest in Action on Hearing Loss. Volunteers are a key part of our teams and your contribution is valued.
Action on Hearing Loss was set up in 1911. Since then we have grown to become a national charity employing 800 people, with significant support from volunteers. Our annual turnover of £45 million means we have the resources to make a real difference to the lives of the UK’s 10 million deaf and hard of hearing people.
Action on Hearing Loss’s vision is of a world where deafness and hearing loss are not barriers to opportunity and fulfilment.
Our mission is
- To be a powerful force for change within government, and public and private sector organisations
- To change radically the attitudes and behaviour of individuals towards deaf and hard of hearing people
- To provide services and support directly to deaf and hard of hearing people and their families to improve their everyday lives
- To be a catalyst for social, medical and technical research to improve the lives of people with a hearing loss and those with tinnitus.
We seek to work in partnership with those who share our Vision and Mission
All Action on Hearing Loss Volunteers will be trained and supported by us. Action on Hearing Loss policies and procedures are in place to guide your work and to help to keep you safe whilst you are volunteering with us.
Criminal Records
Criminal records will be taken into account only when the conviction is relevant. Declaring a conviction will not prevent you from being considered for a post. You will be asked to disclose convictions which are not ‘protected’ under the Rehabilitation of Offenders Act 1974. The Role Description will tell you if this applies to the volunteering opportunity.The offer of volunteering for one of these positions will be subject to satisfactory enhanced and barring list checks for criminal records with the Disclosure and Barring Service, AccessNI or Disclosure Scotland before the appointment is confirmed.
Applicants should tick “Yes” in the relevant section of the application form if you have any criminal convictions. Applicants for posts that are exempt from the Rehabilitation of Offenders Act 1974 (which will be stated on job description and person specification) who tick “yes” are also required to provide further information on convictions, cautions, reprimands in a sealed envelope marked, Head of Volunteering Development, Private and Confidential.
We aim to make sure that you will find your time with Action on Hearing Loss satisfying and rewarding.
This information is available in large print and other formats.
Contact us for more detailsat
Volunteer Role being applied for:______
For more information on volunteering opportunities within Action on Hearing Loss please visit:
Contact details
Title: ______
Name: ______
Address: ______
______Postcode: ______
Tel/Textphone: ______Mobile: ______
Email: ______
Personal profile
Please give us as much information as possible. Whilst we try to ensure that applicants are matched to volunteering opportunities, this cannot be guaranteed.
What skills and experience can you bring to volunteering for Action on Hearing Loss (This may be work-related or gained through volunteering, training and education, personal experience as well as hobbies such as sports, music, arts etc).What do you hope to gain from volunteering with Action on Hearing Loss(E.g. meeting and working with new people, gaining confidence, a better understanding of hearing loss)
Do you have a hearing loss?
□ Yes □ No
Do you have experience of working with people with hearing loss/deafness?
□ Yes □ No
Is British Sign Language (BSL) your first or preferred language?
□ Yes □ No
Do you have any access or support requirements? (e.g. large print, a BSL Interpreter, induction loops, wheelchair access) If yes, please specify:
……………………………………………………………………………………………………………………
Availability and time commitment
When are you looking to volunteer?
On a weekly basis
On a monthly basis
For one off events (tick where appropriate)
Are you normally available during:the daytimethe evening at the weekend
I would also be interested in the following volunteer activities (please tick five )
Supporting people in residential care settings / Take part in our research panelsProviding hearing aid maintenance support / Run an information stand
Running or hosting a peer support group / Social media support
Campaigning for better access to services / Distribute leaflets to GP surgeries
Lead or take part in a Campaign Squad / Place collection cans in local shops
Carry out fundraising collections on the high street or public place / Provide a personal case study
Carry out a bag pack in a supermarket to raise money / Be a hearing check ambassador
Presentations or public speaking about the cause / Write to your local newspaper about our campaigns
Host a local fundraising event / Steward at a marathon or other events
Do interviews with newspapers, radio and TV / Talk or write to MPs about our campaigns
References:
Should you be offered a volunteering opportunity with Action on Hearing Loss, we will need to undertake two references for you.
One referee should be your current or most recent employer or from the agency where you last volunteered.
- Name:______
Address: ______
______Postcode: ______
Telephone/Textphone: ______Email ______
Relationship to you: ______
- Name:______
Address: ______
______Postcode: ______
Telephone/Textphone: ______Email ______
Relationship to you: ______
Do you have any Criminal Convictions you need to Disclose?Please note for ‘Disclosure Scotland’ checks there are no ‘protected’ convictions or cautions.
If “yes”, declare convictions in a sealed envelope marked ‘Head of Volunteering, Private and Confidential, Addressee Only’and send to:
Jane Bailey, Head of Volunteering Development, Action on Hearing Loss, Community Base, 113 Queens Road, Brighton BN1 3XG / Yes No
The Action on Hearing Loss takes very seriously its responsibilities for the safety and welfare of its service users, its volunteers and the organisation as a whole.
Criminal records will be taken into account only when the conviction is relevant. Declaring a conviction will not prevent you from being considered for a volunteer role. Unless the nature of the work demands it, you will not be asked to disclose convictions which are ‘spent’ under the Rehabilitation of Offenders Act 1974. However there are certain roles in Action on Hearing Loss are exempt from the terms of the Rehabilitation of Offenders Act 1974, and for these you are required to disclose all criminal convictions, including those which are ‘spent’. Consideration for these roles will be subject to a satisfactory criminal records check and POVA/POCA check with the Criminal Records Bureau before the appointment is confirmed. This check will request details of cautions, reprimands or final warnings, as well as convictions.
We will contact you if further information is required.
Action on hearing Loss values your support and promises to respect your privacy. The data we gather and hold is managed in accordance with Data Protection (1998). We will not disclose or share personal information supplied by you.
Data Protection Act: I understand and agree that, as part of volunteering with Action on Hearing Loss my details may be held in a confidential database that is only used for reasons relating to my volunteering.
Signature:______
Date:______
If you have any difficulties completing this form please contact the Volunteering Administrator by e-mail:
Return this form to: Kelly Broome, Action on Hearing Loss, Community Base, Room 106a, 113 Queens Road, Brighton, BN1 3XG or email:
For monitoring purposes, please complete the attached Equal Opportunities form and return it to us
Action on Hearing Loss promotes equal opportunities
Received:Interview date:
Interview confirmed:
Induction training invite:
Attendance confirmed
Last updated October 2014
Document owner: Volunteering Development team
Equal Opportunities Policy in Recruitment and Selection
Our volunteer recruitment processes are carried out in a way that ensures that individuals are selected purely on the basis of their ability to do the role for which they have applied. No volunteer will receive less favourable treatment on the grounds of sex, marital status, disability, race, ethnic origin, nationality, age, sexual orientation, religious belief or political opinion or be disadvantaged by conditions or requirements which are not justified or relevant to the role. The sole criterion for selection is the suitability of the applicant for the role. We are committed to ensuring that every applicant applying for a volunteer role within Action on Hearing Loss is treated fairly.
Monitoring
We will treat the following information as confidential and we would appreciate your co-operation in helping us monitor the effectiveness of our Equal Opportunities Policy. Your application will not be affected by the information provided and will be separated from your application form on receipt.
Role applied for
Date
Where did you hear about the vacancy?
Newspaper – please state title
Action on Hearing Loss websiteEnquired at office
Jobs in charities websiteWord of mouth
Other – please state
- Male/Female
- Do you consider yourself to have a disability?*Yes/No
If yes, please provide further details:
*The Disability Discrimination Act 1995 defines a disabled person as someone with a physical or mental impairment, which has a substantial and long-term adverse affect on their ability to carry out normal day-to-day activities.
Age Group
25 and under46 – 55
26 – 3556 – 65
36 – 4566 +
- What is your ethnic group? (Groupings are based on the categories used in the Census in EnglandWales in 2001). Choose 1 section from (a) to (e) then tick the appropriate box to indicate your cultural background.
a)Whiteb)Mixed
BritishWhite & Black Caribbean
IrishWhite & Black African
Any other White backgroundWhite & Asian
Any other mixed background
c)Asian or Asian Britishd)Black or Black British
IndianCaribbean
PakistaniAfrican
BangladeshiAny other Black background
Any other Asian background
e)Chinese or other ethnic group
Chinese
Any other
Sexuality
Lesbian Gay
Bisexual Heterosexual
I do not wish to disclose my sexual orientation.
Religious/Beliefs
Atheism Buddhism
Christianity Hinduism
Islam Jainism
Judaism Sikhism
Other I do not wish to disclose my religion/belief
1