Volunteer Application Form
The following information will be treated in the strictest of confidence
and subject to the provisions of the Data Protection Act 1998.

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Email *
Title
First Name
Last Name
Other Surnames
Other Forenames
Dates From and To
Other Surnames
Other Forenames
Dates From and To
Home Telephone
Mobile
Email
National Insurance Number
Passport Number
Nationality on Passport
Country of Issue
Date of Issue
MM
/
DD
/
YYYY
Driving License Number
Driving License Date of Issue
MM
/
DD
/
YYYY
Date of Birth
MM
/
DD
/
YYYY
Birth Certificate Issue Date
MM
/
DD
/
YYYY
Place of Birth (Town)
Place of Birth (Country)
Current Address
Previous Address (5 Years History Required)
Are You Disabled?
Clear selection
If Yes, if any what support do you require from us?  Anything you think we should know to help you in your volunteering role?
NEXT OF KIN DETAILS in case of an emergency - Name:
Relationship:
Address:
Postcode:
Mobile Number:
Work Number:
Home Number:
Name:
Relationship:
Address:
Postcode:
Mobile Number:
Work Number:
Home Number:
References - Volunteer Role:
How Many Hours or Days To Volunteer:
Referees Required - Name:
Address & Postcode:
Telephone:
Email:
Relationship To You:
Name:
Address & Postcode:
Telephone:
Email:
Relationship To You:
Deceleration by the applicant - Do you have any convictions cautions, reprimands of final warnings which would not be filtered in line with current guidance in relation to the undertaking of a DBS discourse:
Clear selection
By signing the application declaration box I confirm that the information that I have provided in support of this application is complete and true and understand that knowingly to make a false statement for this purpose may be a criminal offence.
Declaration By Applicant
Date
MM
/
DD
/
YYYY
DBS Consent - I consent to Resolven Building Blocks undertaking a DBS and I consent to details given for DBS application being held by WCVA Criminal Records Unit.  These non-sensitive details are held and processed by WCVA on computer and are used for administration purposes only and in accordance with DP ACT 1998.  WCVA CRU will not keep any sensitive information contained on the DBS certificate that is returned from the DBS.
Signed:
Date
MM
/
DD
/
YYYY
Why are you interested in this role, and what do you hope to get out of volunteering?
What skills and experience do you have that you could bring to this role?
Have you volunteered before?
Clear selection
What have you enjoyed most about your previous volunteering or work experience?
Was there anything you didn’t enjoy about your previous volunteering or work experience?
Are there any tasks you would not like to do as a volunteer?
Are there any additional needs or practical requirements that you would want to carry out the role?
Is there anything you would like to ask us?
Information Deceleration - I declare that the information given in this form is complete and accurate. I understand that any false information or deliberate omissions will disqualify me from employment or may render me liable to summary dismissal. I understand and expressly agree that these details will be held in confidence by the Company, for purposes of ongoing personnel administration and payroll administration in compliance with the Data Protection Act 1998.  I undertake to notify the Company immediately of any changes to the above details.
Print Name:
Signed:
Date:
MM
/
DD
/
YYYY
Volunteer Agreement - This agreement tells you what you can expect from us, and what we hope to gain from you.  We aim to be flexible, so please let us know if you would like to make any changes. Resolven Building Blocks will: Introduce you to how the organisations works and your role  in it and to provide any training you need.. Provide regular meetings so that you can tell us if you are happy with how your volunteer work is organised and get feedback from us.. Respect your skills, dignity and individual wishes and do our best to meet them.. Reimburse any agreed out of pocket expenses incurred by your volunteering Consult with you and keep you informed of possible changes.. Provide a safe workplace.
You will: Volunteer reliably and give as much warning as possible whenever you cannot volunteer when expected.. Follow rules and procedures, including health and safety, equality and diversity, confidentiality..  Abide by the terms of the Data protection Act 1984
Signed Volunteer:
Date:
MM
/
DD
/
YYYY
Print Name:
Signed Employee:
Date:
MM
/
DD
/
YYYY
Print Name:
Note this agreement is in honour only and is not intended to be a legally binding contract.
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