VOLUNTEER APPLICATION FORM

Role Applied For………………………….. Location………………………………..

Mr/Mrs/Miss/Other (delete as applicable)

Forename(s)………………………………………………………………………......

Surname…………………………………………………………………………………………………………

Current Address……………………………………………………………………......

…………………………………………………………………………………………………………………..…………………………………..Post Code……………………………………………………………………

Telephone Number(s)…………………………………………………………………………………………...

Email Address…………………………………………………………………………………………………..

Date of Birth …………………………………………………………………………………………………..

Do you have any previous relevant experience? Yes/No

If Yes please give details…………………………………......

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Do you have any other skills which may be relevant to this position? Yes/No

If Yes please give details ………………………………………………………………...………………………………………………..………………………………………….……………………………………………………………………….…………………………………………………………………………………………………………………..

Why would you like to volunteer with us? ......

Please select the reason you have chosen to volunteer with us:

Volunteer Work experience College/University Other please state

How often would you like to volunteer? (Roughestimate of days/hours per week)……………………………………………………………………………………………………………

EMERGENCY CONTACT DETAILS (people to contact in case of emergency)

1st CONTACT

Name (and relationship to you)……………………………………………………………………………......

Home Telephone Number ……………………………………………………………………………………...

Mobile Telephone Number……………………………………………………………………………………..

2nd CONTACT

Name (and relationship to you)…………………………………………………………………………………

Home Telephone Number ……………………………………………………………………………………...

Mobile Telephone Number …………………………………………………………………………………...

P.T.O

Do you have any other skills that you feel you could offer in other voluntary roles throughout the sanctuary? E.g. Ground maintenance, education, hospitality and catering, computing, repairs etc………………………

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REHABILITATION OF OFFENDERS ACT 1974

You are required to declare any criminal convictions (including bind over and cautions) which are not “spent” in accordance with the Rehabilitation of Offenders Act 1974.

No, this does not apply to me Yes, I have the following unspent conviction(s)

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REFERENCES

Please give contact details for two Personal References. This must be someone who has known you for at least a year and is not a family member.

Name …………………………………………………………………………………………………………...

Email Address…………………………………………………………………………………………………..

Address ………………………………………………………………………………………………………… Telephone Number……..……………………………………………………………………………………….

Name …………………………………………………………………………………………………………...

Email Address …………………………………………………………………………………………………

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

Telephone Number……..……………………………………………………………………………………….

References checked by:…………………………………… Date…………………………………………..

DISCLAIMER

All information given on this form will be treated as confidential and is covered by the Data Protection Act.

I hereby agree that while I am Volunteering at The Mare & Foal Sanctuary, they will not be responsible for any damage to my property.I confirm that all information given on this form is correct to the best of my knowledge. I also give permission for Sanctuary staff to treat, or arrange treatment for any medical problem as necessary. Please inform us about any relevant medical issues that you think we should be aware of. We strongly recommend that you ensure that your tetanus inoculation is up to date if working with horses.

Signed …………………………………………………………………………………………………………......

Print Name ……………………………………………………………………………………………………...

Date ……………………………………………………………………………………………………………

Would you like to become a supporter of The Mare and Foal Sanctuary and be added to our mailing list? Yes No