Level 2 Alabaré

DBS REQUIRED

Volunteer Registration Form

When volunteering for Alabaré you may be involved in many different aspects of the work including, Homes and Services for Veterans, Learning Disabilities, Young People, Generic Homelessness, Shops, Chaplaincy and Central Services.

Where did you hear about this Role?
Personal details
Title: Mr □ Mrs □ Miss □ Ms □ Other (please specify)
First name(s):
Surname:
Email:
Contact Address:
Postcode:
Tel Day: Eve:
Mobile:
Volunteering
If you know what role or type of volunteering you would like to do, please give details of this. If you are not sure look at the options below.
Office/computer skills
Administrator / Desktop pub/Graphic design
Fundraiser / Internet/Social media
MS Office skills / Project Manager
Receptionist / Web skills
Working with individual & groups of people
Befriender / Mentor/Life skills / Sleep overs
Working with Elderly / Working with Learning disabilities
General interests/Leisure/other skills/vocations
Other Languages Spoken / Arts & Crafts
Café worker / Cook
General interests/Leisure/other skills/vocations cont…
DIY skills / Driver with own vehicle
Finance/Budgeting experience / Gardener
Keep fit / Leisure passion……………………………..
Organising activities / Shop assistant
Window cleaner / Other ……………………………………………
Are you currently using Alabaré Services Yes / No
Availability
How regularly do you wish to volunteer?
Monthly □ Fortnightly □ Weekly □ More often □
When would you be available to volunteer?
Please tick the hours you are available to volunteer, but
note that not all roles are available at all times.
* AM will normally be until 1pm and PM from 1pm / AM* / PM* / Evening
Mon
Tues
Wed
Thurs
Fri
Sat
Sun
Additional information
Do you have a current driving licence?: Yes □ No □
If yes, do you have the use of a car?: Yes □ No □
Other Languages Spoken
Do you have the right to volunteer in the UK?: Yes □ No □
If you are here on a visa, there may be restrictions.
About you
What interests, skills and experience could you bring to Alabaré? Please give examples from your home or work life and include why you would like to volunteer for us.
Special requirements
We welcome applications from volunteers with disabilities. Do you have any special requirements/health issues that you would like to tell us about or that may have an impact on the activity that you can do?
Status
□ In education □ Looking after home or family
□ F/T employment □ Out of work due to sickness/disability
□ P/T employment □ Carer
□ Retired □ Other (please specify)
□ Unemployed
References
Please give details of two referees. Both should know you well and for a minimum period of twelve months. Referees should not be family members. We will only contact them if you are accepted as a volunteer.
Please supply, if at all possible Email addresses and/or Mobile numbers for your referees. Thank you
Referee one / Referee two
Name:
Address:
Telephone:
Email:
How do you know this person?
How long have you known them? / Name:
Address:
Telephone:
Email:
How do you know this person?
How long have you known them?
Date of birth
Are you under 18? If yes, please give you date of birth.
Medical information
Please let us know if:-
-  You currently receive medical treatment or medication?
-  Have consulted a medical professional in the last year for any health problems?
-  Are having any/awaiting any investigations of any kind at the moment?
Answers
Next of kin / Contact in case of emergency
(if different from Next of kin)
Name:
Address:
Telephone (home):
Telephone (work):
Mobile:
Email:
Relationship to you: / Name:
Address:
Telephone (home):
Telephone (work):
Mobile:
Email:
Relationship to you:
Data protection act
Your personal details will be treated as confidential and kept for no longer than necessary. If you are accepted as a volunteer, the information you have provided on this volunteer registration and monitoring information form will become part of your volunteer records which will be used to plan and record your practical involvement as a volunteer.
We would like to keep you informed about Alabaré News, fundraising events and volunteering activities other than the one you have applied for. If you do not want to be contacted about these opportunities, please tick if you are not happy to be contacted by:
Phone □ Post □ SMS text □ Email □
Declaration
I am aware that the information I have provided will be treated confidentially and consent to it being used and stored in the capacity stated:
I understand that in undertaking Volunteer work with Alabaré Christian Care and Support I may have access to
confidential information. I agree to comply with the charity’s policies and further understand that I will not disclose confidential information to any outside individual or agency without permission from an authorised person.
I confirm that the information I have given on this form is correct and complete and that misleading statements may be sufficient grounds for cancelling any agreements made.
Signature:
Date:

This form is to be completed by over 18’s only. You will need parental consent if you are under 18.

Parent / Guardian Name …………………………………………………. Signature……………………………………………….

Please return completed form to:
Office use only
Date received: Volunteer Code:
Notes:

Volunteer monitoring information

We welcome interest from anyone wishing to volunteer for Alabaré. We aim to reflect the diversity of the local community in terms of ethnic and cultural background, gender, age and disability. Therefore, we ask all potential volunteers to complete the details below. The information will be used for compiling statistics for monitoring purposes and will be treated confidentially.

Please note that the completion of any part of this form is entirely voluntary.

Ethnic group
Black or Black British
□ Caribbean
□ African
□ Other Black
background / Asian or Asian British
□ Indian
□ Pakistani
□ Bangladeshi
□ Other Asian
background / White
□ British
□ Irish
□ Other White
background / Mixed
□ White and
Black
Caribbean
□ White and
Black African
□ White and
Asian
□ Other Mixed
background / Chinese or Other
□ Chinese
□ Any other
Where ‘other’ is ticked, please provide further information:
Gender
□ Male □ Female
Age
□ 15 or under □ 16-17 □ 18-24 □ 25-34
□ 35-44 □ 45-64 □ 65+
Sexual orientation
□ Heterosexual □ Homosexual □ Bisexual
Religion
Disability
Under the Equality Act 2010, a person is defined as disabled if they have a physical or mental impairment which has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities.
Would you consider yourself to be disabled as defined under the Equality Act 2010?
□ Yes □ No
If you have answered yes to the above question, please indicate which category best describes your disability:
□ Hearing □ Mental health
□ Sight □ Physical/motor disability
□ Speech impairment □ Language disability
□ Learning difficulties □ Other (please specify):

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