Luton Culture Volunteers – Application Form
Volunteer Vacancy

Which volunteer role are you applying for? This form can be used to apply for one or more roles at a time

Your Details
First Name
Second Name
Date of Birth
Gender / Female / Male
Address / Postcode
Email
Mobile
Your Health & Safety/Additional Support Needs

Please use the “Volunteer Additional Support Needs Form” to give us details of any access requirements or health condition that we should be aware of. This information will allow us to ensure your time with us is safe and enjoyable.

Skills/ Experience

Please tick any that apply to your previous work or volunteering experience, education, training or pastimes

Stewarding / Front of House / Retail / Hospitality / Fundraising
Event Planning / Research / Conservation / Archaeology / Object Handling
DIY/Repair / Gardening / Data Entry / Money Handling / Cataloguing/Filing
Archiving / Music/Singing / Illustration/Design / Photography / Videography
Crafts i.e. knitting / Theatre/Dance / Teaching – 0-5yrs / Teaching – 6-12yrs / Teaching – 13-24yrs
Teaching – 25yrs+ / Teaching – SEN / Storytelling / Mentoring / Advising
Telephone Skills / Social Media / Blogging / Editing/Proofreading / Marketing
Public Relations / Microsoft Office / Customer Service / Verbal Communication / Team Work
Numeracy / Reading/Writing / Listening / Organising / Leadership
Lone-working / Reliable / Confident / Proactive / Languages – Please Expand below
Tell Us More…
Please use the space below to tell us more about why you would like to volunteer for Luton Culture
Emergency Contact Details
First Name
Second Name
Relationship
Mobile/Tel.
Are You Entitled to Volunteer Within in the UK?

If you are from the UK, you are free to volunteer. The majority of EU citizens are free to volunteer within the UK. For those outside the EU you will need to check that your visa allows you to volunteer. We advise you to contact the UK Border Agency to find out about your eligibility to volunteer.

Yes / No
Criminal Convictions

You must tell us about any unspent criminal convictions you have - in line with the Rehabilitation of Offenders Act 1974. The information you provide will be treated as strictly confidential and will be considered only in relation to this role. If you disclose a conviction, it doesn't necessarily mean that we will not consider and appoint you. Our main consideration will be whether the offence would make you unsuitable for the type of work. Further information in relation to any conviction may be required. You must also state spent convictions, pending charges/current police investigations, bind overs, warnings/cautions or reprimands as you will be working with under 18’s.

Yes / No
Offence
Date of Conviction
References

Two referees (minimum of one), who are over 18 years old. A current or past employer is preferable. Alternatively: volunteer supervisor, teacher, tutor, mentor, head teacher, medical professional, faith leader, community leader, or career advisor. We cannot accept family members as references.

1. Name
Relationship
Address / Postcode
Email
Mobile/Tel.
2. Name
Relationship
Address / Postcode
Email
Mobile/Tel.
Declaration
Signed / Date

IMPORTANT: If you are aged 14-17yrs then please have a parent or guardian to complete the section below

I, the parent/guardian of the above named, give my consent for his/her participation as a volunteer with Luton Culture.

Signed / Date

Thank You! Please return your completed application form via email, post, or by hand.

Email:

Address: The Volunteering Team, Luton Central Library, St Georges Square, Luton, LU1 2NG

Luton Culture Volunteers – Additional Support Needs
Luton Culture - Declaration
The information in this form will be held confidentially and reviewed by the volunteer and their lead supervisor together. You only need to provide information that you are comfortable sharing and that relates to the placement. This form will help us to agree, together, how to practically support you in your role and address any health needs.
·  In line with Luton Culture’s Equal Opportunities Policy, any opportunity will be made accessible to potential volunteers. All additional support needs will be taken into consideration when planning and agreeing on a placement. Reasonable adjustments will be made where and when possible.
·  The information provided will not be used as part of the selection process.
·  All additional support needs will be taken into consideration when completing a risk assessment.
Disability
Disability is defined by the Disability Discrimination Act as; A physical or mental impairment, which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities. The disability could be physical, sensory or mental and must be expected to last at least 12 months.
Do you consider yourself to have a disability? / Yes / No
If yes, please expand
Please identify your additional support needs
Reading, writing work / Number work
Computer skills / Dyslexia
Dyspraxia / AD (H)D /ASD
Asperger’s /Autism / Mental Health**
Physical Disability* / Pre-existing /Long-term Injury*
Deaf /Hard of Hearing (B.S.L User – Yes/No)* / Blind/ Partially Sighted*
Pre-existing /Long-term Medical/Health Conditions / English is not the student’s first language
Other Support Needs Identified
Please give details of your additional support needs
Are there ways we can adjust the placement to accommodate your additional support needs?
Are there particular situations/triggers that we need to be made aware of?
Do you need/Will there be external support for the volunteer? i.e. support worker supervision
Please use this space for any further comments
Office Use Only
* Complete an additional form – Personal Emergency Egress Plan **Complete an additional from – Mental Health Support Needs

Declaration

Signed / Date

Thank You! Please return your completed application form via email, post, or by hand.

Email:

Address: The Volunteering Team, Luton Central Library, St Georges Square, Luton, LU1 2NG