Gender*
—Please choose an option—MaleFemale

Full Name*

Contact Number*

Email*

Please let us know why you would like to become a volunteer with us?*

Any past volunteering experience*
—Please choose an option—YesNo

Availability*
MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Kindly mention the time you are available for volunteering:

Have you got any allergies?*
—Please choose an option—YesNo

If yes, please state

Next of Kin Details

Full Name*

Relationship to you*

Telephone Number*

Email address*

Convictions

Have you ever been convicted, warned, reprimanded or cautioned for a criminal offence, or liable in a civil case?*
—Please choose an option—YesNo

If yes, please provide details (in strict confidence). You must disclose all previous convictions; none of these may be considered spent. As we work with vulnerable people, certain volunteer roles are exempt from the provisions of the Rehabilitation of Offenders Act 1974 and any convictions must be declared. Please note that certain volunteer roles will require a DBS check.

Please confirm that all the information given on this form is correct, and please also confirm that you have read and agree to the Volunteer Agreement on Confidentiality which is attached on the following page.