/ Community Parenting Programme
Befriending Lambeth Families

Befriender Volunteer Application Form

Please complete this form and return to or Volunteer Centre Lambeth, 35 Brixton Station Road, London SW9 8PB. If you have any questions please contact the Project Coordinator at (020) 7326 5480.

Applicants must be over 18 years old and undergo an enhanced DBS check for this role.

First name: / Last name:
Telephone/ Mobile: / Email:
Address: / Postcode:
Geographical area where you live: (please choose one)
Brixton
Clapham
Herne Hill/Tulse Hill
North Lambeth (Waterloo, Kennington, Vauxhall) / Norwood (West Norwood, Gipsy Hill)
Stockwell and Oval
Streatham (Hill and Vale)
Other London borough
Outside London
When are you available to volunteer? (please tick all that apply for planning purposes)
Sat / Sun / Mon / Tues / Weds / Thurs / Fri
Morning
Afternoon
Evening
Why do you want to become a volunteer befriender?
Are there any particular skills you wish to develop?
Please describe any qualities and skills you have which might be useful as a volunteer befriender? These may be from paid, voluntary or life experiences.
So we can consider appropriate adjustments, please describe any access needs.
Contact in case of emergency
Name: / Relationship to you:
Telephone/ Mobile: / Email:
Address: / Postcode:
References: Please provide the details of two referees able to comment on your suitability to volunteer. They must have known you for at least one year and should not be a friend or relative. At least one should be a past or present employer, tutor or volunteer manager.
Referee 1 Name: / Referee 2 Name:
Telephone/ Mobile: / Telephone/ Mobile:
Email: / Email:
Address: / Address:
How does this person know you? / How does this person know you?
Contact before training? Yes No / Contact before training? Yes No
Declaration of criminal cautions and convictions:
When working with vulnerable adults and/ or children there is a duty of care to ensure their safety and protection. As this role requires regular meetings with potentially vulnerable adults this role is exempt from the Rehabilitation of Offenders Act 1974 and all volunteer befrienders must undergo an enhanced DBS check. This can be confidentially discussed with the Project Coordinator at (020) 7326 5480.
Have you ever been convicted, charged and/ or cautioned by the police in relation to any criminal offences? / Yes No
Are there any matters outstanding which may lead to a criminal prosecution? / Yes No
Have you ever been dismissed from any paid or voluntary work? / Yes No
If you answer yes to any question please give details:
If you do not declare existing or spent cautions or convictions you may not be selected. However, if you declare any of the above it may still be possible to become a volunteer.
Declaration and Consent:
I give Volunteer Centre Lambeth permission to carry out criminal record checks at enhanced level prior to volunteering. I understand that my National Insurance number may be required for identification purposes.
I confirm that all of the details on this application are correct and accurate to the best of my knowledge. I give Volunteer Centre Lambeth permission to record this information and my contact details from my application confidentially on the database.
Sign Date

Data protection

You have the right to see any information we hold about you on our database and to request changes to information we hold. We never share your details with a third party without your permission. We may compile statistical data but this will never include reference to an individual.


Equal Opportunities Monitoring

Please complete and return this form together with your application form. The following information will be used for monitoring purposes only to assess the effectiveness of the Volunteer Centre Lambeth in line with the organisations equal opportunities and diversity policy. It will be kept confidential and not passed on to any other organisation. Please leave sections blank if you do not wish to complete them.

Date of Birth: / Gender: Female Male Other
Age range: Please tick one
Under 15
15 – 18
19 – 25
26 – 29 / 30 – 34
35 – 39
40 – 44
45 – 49 / 50 – 54
55 – 59
60 – 64
65 – 69 / 70 – 74
75 – 79
Over 80
Employment Status: Please tick one
Employed full time
Employed part time
House person / Retired
Self employed
Student / Unable to work
Unemployed
Ethnicity: Please tick one
Asian:
Bangladeshi
British Asian / Chinese
Indian
Japanese / Pakistani
Other Asian
Black:
African / Caribbean / Other black background
Mixed background:
Asian and White / Black African and White
Black Caribbean& White / Other mixed background
White:
British / Irish
Other white background / Other:
(please specify):
Religion:
Do you consider yourself disabled? Yes No


Volunteer Registration

Would you like to hear about other ways to volunteer?

Volunteer Centre Lambeth would like to keep you up-to-date with new volunteering opportunities. Please tell us a bit more about your skills and interests so we can match you to information about new volunteering roles.

Tell us a bit more about what sort of volunteering roles you are looking for
Please list any experience, skills or qualifications that you think are relevant
What areas of interest you would like to volunteer in? Please tick your top 5 options
Animals
Art and Culture
Children
Disability
Domestic Violence
Drugs and Addiction
Education/Literacy
Elderly
Emergency Services
Employment
Environment / Families
Gay/Lesbian/Bisexual/
Transsexual
Health & Hospitals
Heritage
Homeless/Housing
Human/Civil Rights
International Aid
Legal Aid/Justice
Mental Health
Mentoring / Museums
Music
Politics
Prisoner/Ex offenders
Race/Ethnic groups/
Refugees
Religion
Sport & Outdoor Activity
Women’s Groups
Youth
What would you like to do? Please tick your top 5 options
Administration
Advice/Information and Support
Architecture/ Building Work
Art
Befriending/ Buddying
Business, Management & Research
Campaigning/ Lobbying
Caring
Catering
Community Work
Computers/IT/Web Design
Counselling
Driving
Entertainment
Finance
First Aid
Fundraising / Gardening
General and Helping
Hostel Work
Languages/Translation
Legal work
Local events
Marketing/PR/Media
Mentoring
Music
National Events
Practical Work/DIY
Retail/Charity Shops
Sport Development
Teaching/Training/ Coaching
Trustee/Committee Work
Youth Work

Volunteer Registration Continued

Do of the below apply to you? If you provide this information we may be able to provide additional help to you when applying for volunteer roles. It is not compulsory.
Refugee/asylum seeker
Ex-offender
Unemployed (under 12 months)
Unemployed (over 12 months) / Childcare/caring responsibilities
Mental health needs
Homeless/in temporary accommodation
Disability
How did you hear about the Volunteer Centre? Please tick just one option
Do-it website
Search Engine
LVAC Website
Connexions / College/University
Library
Job Centre
Friend/Family / Passing By
Newspaper
Other
Do you agree to be contacted by the Volunteer Centre*? Yes No
What is your preferred method of contact*? E-mail Phone

Declaration

I give Volunteer Centre Lambeth permission to record this information and my contact details from my application confidentially on the database and act on my behalf in matters relating to volunteering including making referrals to voluntary organisations.

Sign Date

*Data protection

If you have agreed to be contacted we will include you on our email mailing list. Please let us know if you do not want to receive further communications. You have the right to see any information we hold about you on our database and to request changes to information we hold. We never share your details with a third party without your permission. We may compile statistical data but this will never include reference to an individual.

2

This project is funded by the London Borough of Lambeth

and managed by the Lambeth Voluntary Action Council.