VOLUNTEER APPLICATION FORM
If you need help or advice on completing this form please contact Kitty Shiner on 01603 626123
Role Applied For: Community Project Painting and Decorating Volunteer TutorThe contents of this form will be treated as confidential
PERSONAL DETAILSForename: / Surname:
Home Tel: / Mobile:
Work Tel:
Address:
Post Code: / Email address:
Please state how and when is best to contact you:
Email Home phone Work phone Mobile Post
Time/day:
Do you give permission to email you with volunteering opportunities? / Yes / No
Do you have a current driving licence? / Yes / No
Do you have access to a car for volunteering? / Yes / No
If there are any endorsements on your driving licence, please give details below:
EDUCATION HISTORY
School / College / University attended:
Dates of Attendance / From: / To:
Qualifications Gained:
School / College / University attended:
Dates of Attendance / From: / To:
Qualifications Gained:
School / College / University attended:
Dates of Attendance / From: / To:
Qualifications Gained:
EMPLOYMENT HISTORY
Current / most recent employer
Date from / Date to
Name of employer
Address of employer
Job Title
Main Duties
If part-time, state hours per week
Previous employer
Date from / Date to
Name of employer
Address of employer
Job Title
Main Duties
If part-time, state hours per week
Previous employer
Date from / Date to
Name of employer
Address of employer
Job Title
Main Duties
If part-time, state hours per week
Previous employer
Date from / Date to
Name of employer
Address of employer
Job Title
Main Duties
If part-time, state hours per week
If there is insufficient space, please continue on a separate sheet.
VOLUNTARY AND UNPAID WORKDate from / Date to / Frequency
Name of organisation
Address of organisation
Function of organisation
Role description
Reasons for leaving
Date from / Date to / Frequency
Name of organisation
Address of organisation
Function of organisation
Role description
Reasons for leaving
Date from / Date to / Frequency
Name of organisation
Address of organisation
Function of organisation
Role description
Reasons for leaving
Date from / Date to / Frequency
Name of organisation
Address of organisation
Function of organisation
Role description
Reasons for leaving
If there is insufficient space, please continue on a separate sheet.
With reference to the volunteer role description (attached), please state your reasons for wanting to volunteer for the Matthew Project:Do you have specialist skills, training, interests or hobbies that you would like to use when volunteering with the Matthew Project? Please give details of any courses you have attended e.g. course title, dates and qualification (if applicable)
Please state your availability:
(You will be expected to work a number of hours between 9am and 5pm or after 5pm; we do not necessarily expect you to commit to a full day or full evening. Please refer to the enclosed role description for details on the proposed weekly hours.)
Mon / Tues / Wed / Thurs / Fri / Sat / Sun
9am-5pm Evenings / 9am-5pm Evenings / 9am-5pm
Evenings / 9am-5pm Evenings / 9am-5pm Evenings / 9am-5pm Evenings / 9am-5pm
Evenings
Weekly commitment:
1-5 hours pw / 6-10 hours pw / 11-15 hours pw / +15 hours pw
Please state age if under 21 years old:
Note: due to the client base that we work with, all volunteers must be over 18 years old
REFERENCES
Please give the names and contact details of two people.
This must be your current line manager if you are working or your most recent line manager if you are not working.
Other suitable references are people who have known you for some time in a professional context, such as a teacher, colleague or a supervisor for other voluntary roles. We cannot accept references from relatives or friends.
Please contact us if you need advice on who to provide as a suitable reference.
1 / Name:
Job Title:
In what capacity do you know the person:
Line ManagerColleagueTutor or Teacher
Other professional contact (please specify)
Address:
Tel: / Email:
2 / Name:
Job Title:
In what capacity do they know you:
Line Manager ColleagueTutor or Teacher
Other professional contact (please specify)
Address:
Tel: / Email:
CRIMINAL RECORD
Applicants are required to state whether they have any convictions.(Please tick which applies)
I have none to declare
I have information to declare and have attached a sealed envelope containing details.
The nature of this post means that it is exempt from those provisions of the Rehabilitation of Offenders Act, 1974 that allows convictions to be regarded as ‘spent’. Furthermore, because the duties of the role may involve substantial access to children, any appointment is also subject to a check of police records. All applicants must state whether they have any convictions, cautions or bind-overs. Any information given will be treated in complete confidence. Any failure to declare any convictions, cautions or bind-overs which subsequently come to light will be treated very seriously and may result in withdrawal of the volunteering opportunity.
The Matthew Project welcomes applicants from all backgrounds and we welcome applicants who have had previous drug histories or are ex-offenders for example. There are some restrictions to who we can accept as a suitable volunteer. Due to the nature of our work we cannot accept volunteer applicants who:
- are under 18 years of age
- have experienced problematic and/or illicit drug use or problematic alcohol use within the last 2 years – problematic drug includes the misuse of prescribed medicines
- are using a methadone script
- present a conflict of interests i.e. currently working in a bar or nightclub, a family member of a Matthew Project employee within the same team
- have recent criminal offences within the last 2 years, or have a history of violent offences within the last 5 years
- have been receiving a service from The Matthew Project within the last 6 months.
DECLARATION
(Please read this carefully before submitting the application)
By submission of this application I confirm that the above information is complete and correct and that any untrue or misleading information will give The Matthew Project the right to terminate the volunteer agreement.
I confirm that I have read the enclosed volunteer role description and that to the best of my knowledge I meet the criteria as set out in this role description.
I consent to the collection and storage of my personal data for the uses set out in the Data Protection Statement above.
Please send the completed application in an envelope marked ‘Confidential’ to:
HR Services - The Matthew Project
Nedeham House
22 St Stephens Road
Norwich
NR1 3QU
All applications will be scored against the essential criteria as set out in the volunteer role description. Successful short-listed applicants will be invited for interview. All applicantswill be notified of our decision in writing.
ADDITIONAL INFORMATION
Are you related to, or do you know anyone who works for The Matthew Project? Yes No
If yes, please give the name of the employee and your relationship to them:
EQUAL OPPORTUNITIES MONITORING FORM
The Matthew Project is committed to promoting fairness and eliminating discrimination from volunteer recruitment and selection practices. We will ensure that no volunteer or volunteer applicants receive less favourable treatment either directly or indirectly, on the grounds of age, race, disability, gender, marital status, religion or faith or sexual orientation.
To monitor and audit the effective delivery of this commitment, The Matthew Project requires all volunteer applicants to provide information asked for in this monitoring form. This will only be used for this purpose, will form no part of the selection process and will play no part in our decision on who we accept as a volunteer. The information will be treated as confidential. If you are accepted we will cross reference this form with your application form in order to monitor the effectiveness of our equal opportunities policy.
This form will be separated from your application form on receipt and will be transferred to our Equal Opportunities database to help monitor the diversity of applications we receive. This will enable us to develop appropriate policies and procedures in respect of diversity and equal opportunities.
Your name
Role applied for
Where did you hear about this post? Please give one answer only
Matthew Project website Newspaper, please specify
Word of mouth Other, please specify
Date of birth
Gender? Male Female
Marital status: Married Single Divorced Other, please specify
I would describe my sexual orientation as (please tick):
Bi-sexual
Gay
Heterosexual
Lesbian
Other
Prefer not to disclose
Continued on next page
I would describe my ethnic origin as (please tick):
White BritishIndian
White Irish Pakistani
White other Bangladeshi
White and Black Caribbean Chinese
White and Black African Other Asian background, please indicate
White and Asian Other dual background, please indicate
Black Caribbean Any other: please indicate
Black African Not Stated
Other Black background, please indicate
I would describe my religion or belief as (please tick):
Christian
Muslim
Buddhist
Sikh
Hindu
Jewish
Other, please write in
None
Prefer not to say
Do you consider yourself to have any form of disability? Yes No
If yes, please state the type of impairment which applies to you:
Physical Impairment Learning Disability / Difficulty
Sensory Impairment Long-standing illness
Mental Health Problem Other, please write in
Disability is described by the Disability Discrimination Act as: A physical or mental impairment, which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities. The disability could be physical, sensory or mental and must be expected to last at least 12 months.
Please state how this might affect volunteering with us and any adjustments that may be necessary to support you.
Office Use OnlyShortlisted
Interviewed
Accepted
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