Volunteer Application Form

Second Step is committed to Equal Opportunities. We welcome applicants from all sections of the community

Your Details please complete in BLOCK CAPITALS
Full name / Email
Address / Date of Birth
optional
Phone
No / Home:
Post
code / Mobile:
Voicemail consent
If we try to contact you and you are unable to answer, can we leave a voice mail message/text?
o Mobile o Home number o Text
Which is your preferred area for volunteering? / Bristol / North Somerset (inc WSM)
Where did you hear about us? (if referred by another organisation, please say which one):
Would you like to receive Second Step’s newsletter? / By post / By email / No thank you
Volunteer Roles:
Please choose your top three roles, marking your most preferred role with 1, then 2, then 3. For more information on roles please visit www.second-step.co.uk or see attached document.
Mentor / Befriender / Course support
Peer Mentor / Communications
Service User Engagement / Office Support
Service User Involvement / Volunteer Supervisor
Activity Leader / Walk for Health Volunteer
Your Availability When are you generally available for volunteering?
Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday
AM / o / o / o / o / o / o / o
PM / o / o / o / o / o / o / o
Eve / o / o / o / o / o / o / o
How much time are you willing to give per week? / 4 hours
o / 1 day
o / 1.5 days
o / 2 days
o / 2+ days
o
Are you able to commit for a minimum of 12 months? Please circle / YES / NO
About You Please tell us more about yourself and why you are applying to volunteer at Second Step.
You may wish to write about:
-  What interests you in volunteering for Second Step?
-  What do you hope to gain from the experience?
-  Any relevant work experience or volunteering experience or qualifications.
Skills To understand a little more about you and what you would like to gain from volunteering, please tick skills you already have and skills you would like to learn, or leave blank.
Skill I have / Would
like to learn / Skill I have / Would
like to learn
Reading and Writing / Health and Wellbeing
Using the phone / Fitness and Sport
Emails / Gardening
Internet / Bicycle Mechanics
Basic office skills (filing, photocopying) / Creative Skills
Computer skills / Microsoft Office / Planning group activities
Marketing / Trainer / instructor
Peer Support / Supervision
Mentoring / befriending / Management / team leader
Supporting people / Group Facilitating
Personal Finance / Budgeting
Cooking
Life Experience
We welcome applications from volunteers who have relevant personal experience of related issues such as mental health issues, homelessness, drug/alcohol dependency.
Are you in recovery from Drug or Alcohol dependency? / YES / NO
Have you been free from substance misuse for 6 months or more? / YES / NO
Are you in recovery from Mental Health Issues? / YES / NO
Are you currently receiving any support services, including Second Step? / YES / NO
Have you had personal experience of homelessness? / YES / NO
If you have answered ‘YES’ to any of the above questions, please tell us about your commitment to your recovery and well being.
Support Needs
Letting us know your support needs will not necessarily stop you from volunteering, but helps us to support you in your role and also match you with the volunteering opportunity that best suits you
Do you have any particular support needs such as mental health or access needs? / YES / NO
If yes, please specify:
We look for some key qualities in volunteers – these include social awareness and the ability to work safely with vulnerable people.
What is your understanding of social exclusion and the impact this has on people?
What do you understand by the term ‘boundaries’ and what does this mean to you when volunteering with vulnerable people?
Reference
Please give the details of a person who we may request a reference from and can comment on your suitability for this role. Your referee must not be a friend, relative or service user / client.
Name / Relationship to you
Address / Email
Phone
No
Job Title
Certification and Consent
I certify that the details in this application are correct and agree that any enquiries may be made or documentation requested to substantiate all statements made by me. I give my consent to record this information confidentially, and for it to be used to identify suitable opportunities for me, and for statistical purposes.
Printed Name
Signature – Please type if completing electronically.
Date

Shortlisting is done purely on the basis of this application for, please do not send CVs or other documentation. Please ensure that all relevant information is contained within this form.

Please return to:

Volunteer Services, Second Step, 9 Brunswick Square, BRISTOL, BS2 8PE

If you have any further questions, please contact us: 0117 909 6630

Please complete the Equal Opportunities section on the next page.

Any information you give to Second Step on this form will be treated in the strictest confidence. We will only use this information in accordance with the Data Protection Act for the purposes of combating discrimination and encouraging diversity. This information may be stored on manual and computer files.

Equal Opportunities Monitoring Form

Confidential

Any information you give to Second Step on this form will be treated in the strictest confidence. We will only use this information in accordance with the Data Protection Act for the purposes of combating discrimination and encouraging diversity. This information may be stored on manual and computer files.

A ETHNIC ORIGIN

Do you consider yourself to be:

White

British r

Irish r

Gypsy/Romany/Irish traveller r Please write in ______

Eastern European r

Other White background r Please write in______

Mixed

White and Black Caribbean r

White and Black African r

White and Asian r

Other Mixed background r Please write in______

Asian or Asian British

Indian r

Pakistani r

Bangladeshi r

Chinese r

Other Asian background r Please write in______

Black or Black British

African (Non Somali) r

Somali r

Caribbean r

Other Black background r Please write in______

Other ethnic group

Arab r

Iranian r

Iraqi r

Kurdish r

Turkish r

Any Other r Please write in______

Preferred not to state r

B GENDER

Do you consider yourself to be:

Male / r / Female / r / Transgender / r / Prefer not to state / r

C AGE

16-17 r 18-21 r 22-24 r 25-34 r

35-44 r 45-54 r 55-64 r 65+ r

Prefer not to state r

D DISABILITY

Do you consider yourself to be disabled?

Yes / r / No / r

E If Yes, how would you describe your disability?

Physical Impairment r

Visual Impairment r

Hearing Impairment r

Deaf BSL User r

Learning difficulties r

Specific learning difficulties like dyslexia r

Mental Health & emotional distress r

Progressive disability/chronic illness r

Other r

Autistic Spectrum Condition r

Does not wish to disclose r

F Sexuality

Which sexuality do you identify as:

Gay / r / Lesbian / r
Heterosexual / r / Bisexual / r
Prefer not to state / r

G Which Religion / belief do you most closely identify with?

Buddhist r

Christian r

Hindu r

Jewish r

Muslim r

Sikh r

None r

Other r Please write in______

Prefer not to state r

H Are you EX-ARMED FORCES PERSONNEL?

Yes / r / No / r / Don’t know / r / Prefer not to state / r
Date Form Completed

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OFFICE USE:

Client Reference Number

1

Second Step Volunteer Application Form