/ Work Experience & Volunteering Programme
Application Form

Please complete the blanks or mark with an ‘X’ where applicable.

This form is entirely confidential and all statistics are treated for monitoring purposes only.

Personal Details

Name:
Address: / Postcode: / Borough:
Telephone: / Mobile:
E-mail:
Status:
ILR / EEA Family member / Spouse Visa / Student / British Citizen / EU Citizen / Other
(specify)
When did you arrive in the UK?

Areas / tasks preferred

If you are responding to an advert, to which post(s) are you applying?

Otherwise, please rate from 1 to 5 all of the following areas (1 = of greatest interest):

Housing & benefits (Advice) / Volunteer Management
Domestic Abuse (Advice) / Management or Administration
Psychotherapist/Counselling / Advocacy & Campaigns
Marketing – Communication - Publicity / Interpreting or Translation
Workshops – Events - Fundraising / Other

A Disclosure and Barring Service(DBS) enhanced check will be obtained if the volunteer roleis likely to have direct access to vulnerable adults and/or children or to sensitivedata on vulnerable adults and/or children, on a frequent or intensive basis. If the role is covered by the Exceptions Order 1975 to theRehabilitation of Offenders Act 1974, any spent or unspent criminal convictions will beconsidered when considering suitability for the role in question. If you have been involved in a criminal activity or passed a sentence, this does not mean that you cannot become a volunteer.

1

/ Work Experience & Volunteering Programme
Application Form

Highest Level of Education

Higher education:

Dates / Institution and Country / Level/Grade / Title/Subject

Other relevant trainings and qualifications:

Dates / Institution and Country / Level/ Grade / Title/ Subject

Work experience

Please describe briefly any work experience you have (equal importance will be given to paid or unpaid experience):

Job / Responsibilities / Organization and Country / Duration
From / To

Languages

Mother tongue:

Other languages / Spoken / Written
Basic / Intermediate / Proficient / Basic / Intermediate / Proficient
1.
2.
3.

Reasons for applying

Use this space to describe the reasons you are interested in volunteering.

For instance: Are you looking for work experience? Would you like to develop other skills? What other skills or experience can you offer? You may continue on no more than one additional sheet.

Please complete the following 3 sections if you are applying for a Psychotherapist/Counselling role:

1) Please describe your approach to the work of counselling: what schools or training have influenced your work?

2) Please state face to face 1:1 hours up to this date: ______. Please note that me minimum required hours for a Psychotherapist/Counselling role is a minimum of 150 face to face 1:1 hours.

3)

Professional Association / Membership grade / Date

IT Skills

None / Basic / Intermediate / Advanced
Internet
Word
Excel
PowerPoint
Access

Availability

We require a minimum of 6 months commitment.

Start date: To:

Availability throughout the week (mark with a ‘X’ the time you have available):

For office positions you must have a full day free (from 10am to 6pm).Psychotherapist/Counselling roles are one day per week and compulsory fortnightly supervision (Monday or Tuesday). Other volunteer roles are usually one day per week.

Monday / Tuesday / Wednesday / Thursday / Friday
AM / PM / AM / PM / AM / PM / AM / PM / AM / PM

Current Employment Situation

Part timeNot working Student

Full timeI am looking for Retired

work

1

/ Work Experience & Volunteering Programme
Application Form

Volunteering

Have you ever volunteered before?YesNo

Have you volunteered for another organisation in the YesNo

last 12 months?

How did you find out about LAWRS?

1

/ Work Experience & Volunteering Programme
Application Form
La Tertulia
(website) / Leaflet / Poster / University / Member or former service user at LAWRS
lawrs.org.uk / Internet Search / Church / Word of mouth
charityjob.co.uk / Latin American newspaper / Volunteer Centre / Internship / Work Placement
Other website:
(which one?) / Radio / Other organization (name: ) / Other – state:

Personal Information – Statistical monitoring

In order to monitor our Equal Opportunities Policy and practice with regard to recruitment and selection, we would be grateful if you could complete the following two sections.

Date of Birth: / / / National Origin: / Sex: M / F
Number of children under 16 years of age:
Do you have any disabilities? Of what kind?
Our office is wheelchair accessible. Do you have any other needs or requirements for which we can provide?

Ethnic Origin

Please select the option which best describes you:

Latin American) / Asian o British Asian – Pakistani / Black or Black British – African
Mixed – Other / Asian o British Asian – India / Black or Black British – Other
Mixed – White Asian / Asian o British Asian – Bangladeshi / White – British
Mixed – White Afro- Caribbean / Asian o British Asian – Other / White – Irish
Mixed – White African / Chinese / White – Other
Black or Black British – Afro- Caribbean / Other

1

/ Work Experience & Volunteering Programme
Application Form

References

Only for Interpreting andPsychotherapist/Counselling roles.

For these posts we need the details of two people who know you well, indication in what capacity you know them (not relatives/ family). At least one of whom should have recent knowledge of your work. Referees will be asked to comment on your suitability for the post

We will only seek references if you are offered the role, but these will be required before any formal offer can be made.

All the information given on this form is of a confidential nature.

Referee 1

Name:
Surname:
Profession:
Business / Institution:
Post:
Address (incl. town and country)
Postcode:
Telephone / Mobile (incl. area code):
E-mail:

Referee 2

Name:
Surname:
Profession:
Business / institution:
Post:
Surname:
Name:
Address (incl. town and country):
Postcode:
Telephone / Mobile (incl. area code):
E-mail:

Please send this form to:

Veronica Gutierrez

Volunteer Coordinator

Tindlemanor

52-54 Featherstone Street

London, EC1Y 8RT

Or email to:

Tel. 020 7336 0888

THANKYOU!

1