VOLUNTEER DRIVERS’ MEMBERSHIP APPLICATION
Please complete this form and email it to or post it to the Regional Co-ordinator, RSVP, The CREATE Centre, Smeaton Road, Bristol, BS1 6XN. Please also supply a passport-sized photograph of yourself (1¾" deep x 1¼" wide, with your name on the reverse) for your RSVP membership identity card, which can be sent separately if you are emailing the form.

Title (Mr/Mrs/Miss/Ms/etc) ………….. Date of birth …………….Gender ……….…….

Forenames Surname

Address

Postcode

Telephone Email

Ethnic origin: Black White Mixed Other I’d rather not say

Local Authority Area……………………………………………………………………………..

Please give details of two referees who can vouch for your suitability and trustworthiness:

Referee 1 Referee 2

Name

Address

Telephone

E-mail

What is each referee’s link to you (i.e., doctor, previous employer, friend, etc)?

………………………………………………………………………………………..

Information about your vehicle:

Valid licence? YES / NO Comprehensive insurance? YES / NO

MOT expiry date Date of last service

Do you have any experience of driving a minibus? YES / NO

If you have a current CRB/DBS check, please give details:

Reference Date

I understand that should I wish to help children, young persons or vulnerable people and have not undergone a CRB/DBS check, it will usually be necessary to apply for disclosure of any information held. I agree that RSVP West may supply the data I give here to its users in accordance with the Data Protection Act 1998.

Signed Date

HELP US TO HELP YOU

Please tell us what kind of voluntary activity you are interested in (tick all that apply):

Helping young people Helping in schools

Befriending others Visiting the housebound

Safeguarding our heritage Improving the environment

Driving minibus or own car Helping older people

Helping people with disabilities Fundraising

Organising or administration Office work

Any other activity not mentioned above:

Are you fluent in a second language? If so, which?

Do you play a musical instrument? If so, which?

What hobbies, interests and skills do you have that might prove useful?

Do you have any additional comments that might help us or you?

How did you hear about RSVP?

For organiser and office use:

Ref 1 / Organiser
Ref 2 / Project
ID card