CONFIDENTIAL Home-Start South & West Devon
Volunteer Application
PLEASE USE BLOCK CAPITALS
Date:
Name:Date of Birth:
Address:Ethnic Origin
Home Tel.:
Post Code:Email:
Please give names of childrenContact in case of emergency
NameAgeName
Address
Tel. No.:
PLEASE GIVE DETAILS OF WORK EXPERIENCE AND USEFUL SKILLS
- remember to include paid and/or voluntary work, parenting skills and personal experience
Home-Start South & West Devon Registered Charity No. 1108077
Company Limited by Guarantee. Registered in England and Wales No.5331020
Registered Office: The Hub, Avon House, 163 Ridgeway, Plympton, PL7 2HJ
How much time can you spare us?Have you any commitments which could affect your (You may tick more than one) work with home-start e.g. part time work?
MORNINGS
AFTERNOONS
EVENINGS
Do you have your own transport?Do you have any health problems?
Any other information you would like to add?
HOME-START SOUTH & WEST DEVON
Home-Start will require your agreement to carry out an enhanced criminal record check from the Criminal Records Bureau before you can be matched with a family. This will include details of cautions, reprimands or final warnings as well as convictions and spent convictions. The nature of the work with Home-Start is such that it is exempt from the Rehabilitation of Offenders Act 1974. But having a police record does not necessarily mean you cannot do voluntary work for Home-Start. You must declare any convictions that occur after completion of the Criminal Records Bureau form and throughout the duration of your involvement with Home-Start. Any information will be kept confidential by the Scheme Manager and will not be disclosed without your permission.
Please give the name and addresses of two referees (not relations) who will confirm your suitability as a Home-Start Volunteer
NameName
EmailEmail
AddressAddress
Post CodePost Code
Telephone Number Telephone Number
Data Protection Act 1998: Names and addresses are stored on our computer system, purely for internal administrative purposes and are only available to other parties following the express consent of the person concerned. I understand that Home-Start South & West Devon may contact me from time to time in order to inform me of other Home-Start activities, for example, fundraising.
I KNOW OF NO REASON WHY I WOULD BE UNSUITABLE TO BE A HOME-START VOLUNTEER
Signed:______Date:______
c:\users\andrea\dropbox\home-start s&wd confidential\volunteers\prospective volunteers\volunteer application form with dp.doc