COVID RESPONSE GROUP
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First Name *
Surname *
Do you have any medical conditions *
Age Bracket (we are collecting this so that we can match age groups with safe and appropriate roles - under 16's are unable to volunteer) *
Gender *
Phone Number *
Email address
City of Residence *
Name of Local Area where you live
Are you a car owner? *
Do you have any other skills that you think might be useful (for example, languages, translation services, specialist knowledge)?
Do you have any medical care work or care worker or social worker experience? Please give details.
What would you be willing to do? *
Availability (Are you Available anytime during 9 -5) *
Are you available during evenings and weekends
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If you are available during 9am to 5 pm can you work from home , assisting in taking calls. How many hours can you work a day and what times
Do you have a Disclosure or PVG (DBS) check? *
Required
If you have a DBS check, what type is it?
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Emergency contact (please include name, relation to you and contact number) *
I agree that personal data relating to me, which has been obtained by WCF, including the data given to me on this form, may be held and processed on computer or manual records and may be disclosed to authorised WCF team members and other organisations involved in the Volunteering programme, relating to my voluntary work. *
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