Today’s date......

Personal Details

First Name ………………….……...... Last Name ………………………………… Mr/Mrs/Miss/Ms

Address ……………………………………………………………….………….………………..….…......

………………………………………………………………………………………………………………… Postcode ……...... …………….

Home Phone …...... ………….Mobile Phone ...... Email......

Equal Opportunities

Age Range: c 15 and under c 16-17 c 18-25 c 26-29 c 30-34 c 35-39 c 40-44

c 45-49 c 50-54 c 55-59 c 60-64 c Over 65

Status: c Employed c Unemployed (seeking work) c Non-employed (not seeking work)

c Self Employed c Unable to work (legally) c Student c Retired

Ethnic Origin: c White British c White other c Asian/Asian British c Black/Black British

c Other; please specify......

Volunteer Profile

Have you done volunteering before? Yes/No If Yes, what kind and for which organisation?

……….………………………………………………………………..………………………………………………………………………..…..…………..

What do you hope to gain from volunteering?

…………………………………...... …......

What kind of voluntary activities would you like to do?

...... ………………..………………………………………………………………......

Which skills do you wish to use as a volunteer?

...... ………………………………………………………………………………….

When are you available to volunteer? c Mornings c Afternoons c Evenings c Weekends

Do you have you own transport? Yes/No

Where are you willing to travel to volunteer? c Wokingham c Finchampstead c Woodley c Earley

c Twyford c Other local e.g. Reading, Bracknell, Crowthorne

c Further afield e.g. Rest of Berks, Bucks, Oxon

Are you willing to undertake training? Yes/No

Where did you hear about us? …....………….…………………………..……………………………………….

Have you registered with anyone else to find volunteering? If yes, who?......

Volunteer Match

We have over 100 volunteering opportunities available. To enable us to match you to an opportunity that meets your needs and skills, please complete the following.

May we contact you in three months to see how you are getting on? We will be emailing you a brief questionnaire to complete. Yes/No

Do we have your permission to hold your contact details electronically? It will be much easier for us to keep you up to date with the Volunteer Centre if we do. Yes/No

Please note: The Wokingham Volunteer Centre will keep your details confidentially. We will never pass your details onto a third party.

The Wokingham Volunteer Centre. Tel: 0118 977 0749. Email: . CIO: 1161498