CONFIDENTIAL

APPLICATION FOR VOLUNTARY ACTIVITY

October 14- Volunteering team

TITLE:______

FIRST NAME:______
SURNAME:______

ADDRESS:______

POST CODE:______

EMAIL______

TEL (DAY)______TEL (EVE)______

MOBILE ______

DATE OF BIRTH ______

October 14- Volunteering team

How did you hear about Blind Veterans UK ?______

What, if any, previous contact have you had withBlind Veterans UK?

______

Why would you like to volunteer at Blind Veterans UK?

______

______

______

______

______

Which Volunteering role/s are you interestedin?

______

______

Please give details of any of your experience/expertise that you feel are relevant to the role of volunteering.

Skills/interests/work experience/training / Any qualifications
Driving roles for Blind Veterans / Details
Do you own your own car? / YES/NO
How far are you prepared to travel? / ...... MILES

All volunteers are expected to undertake induction and relevant training on becoming a volunteer and to have updates as required. Are you willing to participate in these training session Yes/No

Health – because it is our responsibility to ensure the health and safety of all our volunteers, we ask you to give information regarding your health. This is to try to ensure that volunteers are not asked to do anything that would involve a risk to their health.

Please list any serious illnesses/disabilities/ allergies that you have:

______

______

______

Disclosure of Criminal Convictions

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

The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are 'protected' and are not subject to disclosure to employers , and cannot be taken into account.

Guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website.

If you have ticked yes, summarise details below

______
______

Previous convictions will not prevent full consideration of your application to volunteer with Blind Veterans UK.Failure to disclose a criminal conviction whilst securing a volunteering role could result in the end of the volunteer’s involvement. All those applying to volunteer and undertaking specific roles with clients will be asked to apply for a DBS (Disclosure and Barring Service) Enhanced disclosure.

How we use your personal information on this form

The information you have provided on this form will be processed in line with the Data Protection Act 1998. We will keep your personal details safe and will not share them with other organisations.

I understand that my personal details will be kept securely and will be entered onto Blind Veterans UK database system. I agree to Blind Veterans UK processing and retaining the personal information contained on this form for any purposes connected to my application and volunteering.

We would also like to keep you informed about our projects and activities.

Please tick if you do notwish to receive this information by:

Post , Email  Text , or Telephone.

You can unsubscribe at any time.

Signature: ______

Date: ______

Please leave blank for printing purposes.

EQUAL OPPORTUNITIES MONITORING FORM

Blind Veterans UK is committed to an Equal Opportunities Policy and as such seeks to ensure that no volunteer applicant is disadvantaged or discriminated against either directly or indirectly. In order to monitor the effectiveness of this policy it is necessary to collect information from all prospective volunteers on key factors relating to equal opportunities i.e. age, gender, ethnicity and disability.

This information will be used in providing us with statistics to enable us to measure how we are progressing in terms of ensuring equal opportunities.

Please complete the relevant sections below. In those involving a choice we would request that you circle the category that you feel is most appropriate to you.

Please leave blank any questions you do not wish to answer.

Role Applied for:

______

Location of volunteering

Brighton Llandudno Sheffield London Community Based

Which age Group do you belong to:

0 – 18 19 – 44 45 – 64 65+ Prefer not to say

Gender:[If you are undergoing gender reassignment, please circle the option that applies to your future gender]

Male Female Prefer not to say

Sexuality:

Heterosexual Gay Man Gay Woman/Lesbian Bisexual

Prefer not to say

Ethnicity:(Please circle the red optionbeneath the Category that you feel most appropriately identifies your ethnic origin)

White / Black or Black British / Asian or Asian British / Mixed / Other
British / African / Bangladeshi / White & Black Caribbean / Chinese
Irish / Caribbean / Indian / White & Black African / Other Ethnic Group
Other White / Other Black / Pakistani / White & Asian
Other Asian / Other Mixed

Religion: (Please complete or circle as appropriate)

My Religion or Belief is ______

or I have no Religion or BeliefPrefer not to say

Disability:

Under the ‘Equality Act 2010’ the definition of a disability is ‘a physical or mental impairment, which has a significant and long-term adverse affect on a person’s ability to perform normal day-to-day activities’.

Under this act do you consider yourself to have a Disability?(Please circle)

YesNo

If ‘Yes’ please give details______

Thank you for completing this form, please make sure you return it along with your Application Form.

October 14- Volunteering team