Devon Air Ambulance Trust

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Volunteer Application Form

Date of Application:
Please circle what you would like to do for the Trust: / SHOP:
Name: / Mr/Mrs/Miss/Other:
Address:
Post Code: / Date of Birth:
Telephone Home: / Mobile Number:
Email Address: (this is vital as it will be our main way of corresponding with you):
How would you like to be known (this will appear on your id badge):
Present or most recent employment:
Do you have a clean Driving Licence Yes/No / Do you have use of a car? Yes/No

medical information

I t is important that you tell us of any health issues or disability where we might need to make special arrangements, and any additional support needs you may require:

Emergency COntact

Name:
Address:
Phone: / Mobile: / Relationship to you:
Have you any skills or experience that you think will be useful to Devon Air Ambulance Trust (DAAT)?
Was there something in particular that made you decide to offer your time to DAAT?

There are several ways in which you can help. Please tick any of the activities you might be interested in:
⃝ Help in one of our charity shops - shop preferred ......
⃝ Servicing DAAT collection boxes ⃝ Drive/deliver goods for us
⃝ Accepting cheques at presentations ⃝ Help at Head Office
⃝ Giving talks ⃝ Attend events/promote the work of the charity

References

Please supply the names and addresses of 2 referees and state how they know you. Referees can include a previous employer, someone who holds a position of responsibility in the community or a long-standing friend. Family members are not acceptable.
Reference 1: / Reference 2:
Name / Name
Address: / Address:
Postcode / Postcode
Telephone No: / Telephone No:
Email address: / Email address:
How they know you: / How they know you:
Photos: We often use photos of volunteers for our Facebook, Twitter and Website pages, for newspaper and Helipad articles and posters and banners within our shops. If you do not want your photo to be used
please tick the box and let us know if we appear in your vicinity with a camera!
SIGNATURE
Signed: Date:
Please provide a passport sized recent photograph suitable for an official ID Badge.
Thank you for completing this form - please return it to me at Devon Air Ambulance Trust
Unit 5, Sandpiper Court, Harrington Lane, Exeter, EX4 8NS 01392 466666