Volunteer Application Form

Role you are interested in:

Please write in block capitals.

Surname:
First Names(s):
Address: / Postcode:
Date of birth:
Telephone No:
Email address:
Please indicate the days & times when you would be able to regularly volunteer:

Morning

/

Afternoon

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
How long can you commit to volunteering?
How did you hear about The Cardinal Hume Centre?
If a web site, please tell us which one:
What do you hope to achieve from your volunteering?
Please tell us your employment history, starting with most recent andexplaining any significant gaps (gaps will not impede your application)
Date From / Date To / Employer / Job Title and Main Duty
Please tell us about any formal educationyou have undertaken.
Date
From / Date
To / School / College / University Attended / Qualification / Date Achieved
Looking at the role description, please tell us what interests you about the role and about any relevant experience you can bring.
Do you have any needs we should know about so we can support you e.g. literacy, visual or hearing impairments, mobility challenges?
If no, please tick. / If yes, please give details:
Disclosure
The post for which you have applied is exempt from the provisions of the Rehabilitation of Offenders Act 1974 and all applicants must provide details of their criminal record, except for certain spent convictions and cautions which are “protected”* and therefore not subject to disclosure to employers (*guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website )
The information you give will be strictly confidential and will be considered only in relation to this role.
Do you have any convictions, cautions, reprimands or final warnings that are not “protected” as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)
Yes No If yes, please give brief details:
Offence: / Penalty / Conviction Date

I declare that the information contained in this form is correct to the best of my knowledge and I authorise the use of my personal details for internal communication and monitoring only. This information will be stored strictly in accordance with data protection regulations.

Signature: Date:

For Office Use Only

Number of hours: Days in:
Supervisor:
Start date:
DBS check required: (please tick)
Providing a Safe Working Environment

The Centre is committed to ensuring a safe working environment for all staff, volunteers and service users. Ideally, referees should be professional or academic and someone the volunteer has known for at least six months. We can also accept social worker, probation officer, a course tutor, religious leader, volunteer manager. They should not be family or friends.

Referee 1

First Name: / Surname: / Title:
Address: / Phone No: / Email:
How do you know this person?

Referee 2

First Name: / Surname: / Title:
Address: / Phone No: / Email:
How do you know this person?
Emergency Contact Details
Name: / Relationship:
Address: / Same as volunteer? Yes
Postcode: / Telephone no:

Equal Opportunities Monitoring Form

You do not need to complete this form but it is very helpful to us. We use the statistics to inform our volunteer recruitment and tell us if we are fulfilling our equal opportunities policy. We believe that by welcoming people from all areas of society, we are more able to help and support those coming to use our services.

I would prefer not to fill in this form
Date of Birth: / / /
1. I am: Male Female
2. I define my ethnic origin as: Choose only one.
a. White / British Irish Other
Please specify:
b. Mixed / White & Black Caribbean White & Black African
White & Asia Other
please specify:
c. Asian or Asian British / Indian Pakistani Bangladeshi
Other please specify:
d. Black or Black British / Caribbean African Other please specify:
e. Chinese or other ethnic group / Chinese Other
please specify:
2. Do you have a disability? Yes No
For volunteers 16 years and over only:
3. I define my sexuality as:
Gay/Lesbian
Heterosexual (straight)
Bisexual
Other please specify:
I don’t wish to state
Thank you for providing this information

The Cardinal Hume Centre, 3-7 Arneway Street, London, SW1P 2BG. 020 7222 1602