Download Volunteers Registration Pack

Improving the lives of people
with learning difficulties and disabilities
Volunteers Registration Pack.
Please complete this document and return it to:
[email protected]
or to the office at:
People in Action
3rd Floor
Symons House
Belgrave Street
Leeds LS2 8DD
If you need help filling out this document please get in touch:
www.peopleinaction.org.uk
0113 2443729
[email protected]
Registered Charity in England and Wales No. 701434. Company Limited by Guarantee No. 2361654
Improving the lives of people
with learning difficulties and disabilities
Volunteering Application Form
Name
D.O.B.
Address
Tel No
Mobile
Email
What is your preferred method of contact?
Please give details of any disability or medical condition you feel we
should know about…
Have you any particular interests or hobbies (past or present) which
could be shared with somebody?
Have you worked as a volunteer before? (please give details)
2
When are you available to volunteer?
Daytime
Evenings
Weekdays
Weekends
(Mon-Fri)
(Sat – Sun)
Other (please say)
Do you have a full, clean driving license?
Yes
No
Do you have transport available?
Yes
No
Improving the lives of people
with learning difficulties and disabilities
References
Please give the names of two referees, for example: employer, tutor,
long-standing friend (not a relative).
People In Action works with vulnerable people and we always take
up references.
Reference 1
Name
Address
Tel No
Email
Relationship to you
Reference 2
Name
Address
Tel No
Email
Relationship to you
4
Please give details of any criminal convictions (if applicable) so
that we can take them into account when considering your
application. (Exemption under the Rehabilitation of Offenders Act
does not apply)
We have to check with the Criminal Records Bureau for any record of
criminal convictions, which may affect your application. In order to
do this we need the following information:
Date of birth
Name (if you were previously
known by another name).
Date
Signature
(under 18s please get your
parent/guardian to sign for you)
Improving the lives of people
with learning difficulties and disabilities
Photography consent form
People In Action may take photographs or record videos of its
projects or events. This material may be used to promote the work of
People In Action through press and publicity materials, for example
Newsletters, Leaflets and the People In Action website.
Please indicate as to whether you DO or DO NOT permit to the
careful use of your photograph in any of the following:
Leaflet:
Website:
Newsletter:
Name
Date
Signature
6
I DO give permission
I DO NOT give permission
I DO give permission
I DO NOT give permission
I DO give permission
I DO NOT give permission
Volunteer’s Agreement
People In Action are mindful that people’s circumstances may alter
over time and so any commitment made to volunteering may have
to change.
However, as People In Action tries to avoid letting people down, we
would ask you to ensure that you can keep to any commitment you
make to volunteering as far as possible. If any change has to be
made, please try to give as much notice as you can.
I have read and understood People In Action’s Volunteers’ Policy
and agree to the requirements for volunteering with People In Action.
I agree to undertake training in, and work in accordance with,
People In Action’s policies.
I will inform People In Action if I wish to change, or end, my
arrangements for Volunteering.
Please register me as a People In Action Volunteer.
Volunteer’s Signature
Name
Date
Improving the lives of people
with learning difficulties and disabilities
Equal opportunities form
Inline with our equal opportunities policy, People In Action would like
you to answer the following questions. Filling in the form is optional.
This form is only used for monitoring to make sure that our procedures
are as fair as possible.
Gender:
Male
Please tick the boxes
that best describe you.
Female
Do you have
a disability?
Yes
No
Age group:
0 - 11
12 - 20
21 - 30
31 - 40
41 - 50
51 - 60
61 -70
Ethnic origin:
White
British
European
Other – give
details
Mixed
White and Black
Caribbean
Other – give details
Asian or Asian British
Indian
White and
Black African
Pakistani
Bangladeshi
Other – give details
Black or Black British
Caribbean
Other – give
details
Other ethnic groups – give details
8
African
White and
Asian
70 +