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Volunteer Application Form
Application form for volunteers and students.
South Essex Wildlife Hospital, Orsett Road, Orsett, RM16 3BH. Tel: 01375 893893
Applicants Must be over 18 years of age.
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Email
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Your email
Full Name
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Your answer
Full Address & Postcode
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Your answer
Contact telephone number
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Your answer
Email Address
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Your answer
Date of Birth
Applicants must be over 18 years of age
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Next of kin-name & relationship to applicant
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Your answer
Next of kin- Contact number
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Your answer
Do you hold a full UK driving license?
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Yes
No
Do you have any driving convictions?
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Yes
No
Do you suffer any long term medical conditions, including mental health issues
Yes
No
Clear selection
If yes please give further details
Your answer
Please give details of any regular medications you may be taking.
Your answer
That you are aware of do you have any allergies to anything?
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Yes
No
Education & Training
Date from- Date to- Name of establishment- Subject studied-Grade or Award
Your answer
Please Give Details of Current employment.
Start Date- Name of workplace - Brief Description Of Duties
Your answer
Please Indicate What Type Of Volunteer Role You Are Applying For
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Volunteer Animal Care Assistant
Student Animal Care Assistant
Veterinary professional
General maintenance or gardening
Fundraiser
Other:
If other please give details
Your answer
For student roles please indicate when the placement is required from and to, which training establishment you attend and name of course.
Your answer
Please indicate what days you are available to volunteer. Volunteers must commit to at least 1 day per week. Volunteer animal care hours are usually 10am to 6pm but can vary at different times of the year, for example evening animal care shifts are vital during the spring and summer months. During the winter months volunteers can often finish earlier.
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Required
Please tell us of any previous experience relevant to the position being applied for.
Your answer
We ask that you can provide us with the details of 2 people that can give a reference
Reference 1.
Name of Person 1
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Your answer
Address of person 1
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Your answer
Telephone number and email address of reference 1
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Your answer
Reference 2
Name of person 2
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Your answer
Address of person 2
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Your answer
Telephone number & email of person 2
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Your answer
Have you ever been convicted by the courts, cautioned, reprimanded or given a warning by the police and/or had allegations made against you? (as the rehabilitation of offenders exemption order 1975 applies you must disclose convictions regarded as spent under the 'Rehabilitation of Offenders Act 1974)
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Yes
No
If yes please give details
Your answer
Due to the nature of our charity we have a duty of care to our animals, visitors and other volunteers, staff & students. Therefore do you give consent to carry criminal record checks (CRB) on you if required.
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Yes
No
Please tell us why you would like to volunteer with us and how you can contribute to our charity.
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Your answer
The information you have provided in this form constitutes part of the terms of your volunteering contract should you be accepted. Please print name below to agree to the following statement. ' To the best of my knowledge, the information I have provided on this form is truthful.
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Your answer
Date form Completed
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