Job Application Form Bromley Care Services Ltd

2a Fielding Lane,

Bromley

Kent BR2 9FL

Tel: 020 8313 9725

VOLUNTEER APPLICATION FORM

Role applied for: / Personnel Use / Role ref.
Personal
Forename(s): Surname: ______
Address: ______
______
Telephone: ______day ______evening
Email: ______
Referees: Please provide two referees who will be able to comment on your suitability as a volunteer for Community Options.
1) Name: ______Phone No:______
Address: ______
Email: ______
Capacity in which you know the referee ______
2) Name: ______Phone No:______
Address: ______
Email: ______
Capacity in which you know the referee ______
Registration to Professional Body
Professional body / Date of registration / Date of Expiry of registration
Education (inc. Further education and professional qualifications)
School/college/
University / Address and Dates of
Attendance / Qualifications gained and date
Employment - are you currently employed (paid/unpaid) if yes please provide details.
Name and address / Position held and responsibilities / Date
Started
Why you would like to be a volunteer for Community Options? (max 400 words)
What particular skills and experience would you bring? (max 400 words)
PERSONAL DECLARATION: Volunteers will be required to obtain an Enhanced Disclosure certificate from the Disclosure and Barring Service before volunteering role is confirmed
Duetothenatureofthework,thispostisexemptfromtheprovisionsofSection4(2)oftheRehabilitationofOffendersAct1974.
(TheamendmentstotheExceptionsOrder1975(2013)providethatcertainspentconvictionsandcautionsare
‘protected’andarenotsubjecttodisclosuretoemployers,andcannotbetakenintoaccount.Guidanceandcriteria onthefilteringofthesecautionsandconvictionscanbefoundattheDisclosureandBarringServicewebsite.).
Doyouhaveanyunspentconvictions,cautions,reprimandsorwarnings?
If YES, please give full details
SIGNED: ______DATE: ______
FairProcessingNotice:ThedetailsCommunityOptionsandyoufillinontheDBSapplicationformarereferredtothe policeandothergovernmentbodies,tohelpidentifypossiblematchestorecordsheldagainstyou.DBSmay alsouse theinformationprovidedonthecertificate,oranyotherinformationwearemadeawareof,toinformconsiderationof ourbarringdecisions(theSafeguardingVulnerableGroupsAct2006,enablestheorganisationtocarrythisout).

Failure to disclose any relevant information or providing false or inaccurate information may result in you being asked to no longer volunteer for the organisation.

DECLARATION:
1) Are you related to a current employee or committee member? If yes, please give brief details
______
2) Do you currently receive a service from Community Options? If yes, please give brief details
______
All the information I have given here is true. I consent to the use of all this information when considering my application, and understand that:

It will be treated confidentially at all times;
If I am successful it will form part of my records;
If I am unsuccessful the information will be destroyed after six months

SIGNED: ______DATE: ______

Any information contained in this form will be treated inconfidence. Failure to disclose any relevant information or providing false or inaccurate information may be regarded as a breach resulting in you being asked to no longer volunteer for the organisation.

Return to: Community Options, 2a Fielding Lane,Bromley, KentBR2 9FL
MONITORINGPOST:NO:
Community Options operates policies designed to ensure that all applicants are treated equally, regardless of race, religion, ethnic origin, age, sex and disability. In order to monitor whether or not such policies are effective you are asked to provide the following information. This information will not be used in assessing your suitability, it will not affect your application but will assist us in identifying possible barriers in the recruitment process which will help us eliminate discrimination.
Please tick appropriate box?
Male / Female / Prefer not to say / Age / Prefer not to say
How would you describe your ethnic origin? Please tick one box.
1 / British
2 / White / Irish
3 / Other
4 / White and Black Caribbean
5 / Mixed / White and Black African
6 / White and Asian
7 / Other
8 / Indian
9 / Asian or / Pakistani
10 / Asian British / Bangladeshi
11 / Other
12 / Black or / Caribbean
13 / Black British / African
14 / Other
15 / Chinese
16 / Other / Other Ethnic Background
17 / Not Stated
Do you have a disability? / Yes / No / Prefer not to say
Have you experience mental illness? / Yes / No / Prefer not to say
Where did you see this role advertised?
I consent to Community Options processing this information for monitoring purposes, on the understanding that it will not be divulged to any person considering my application for positions with the organisation.
SIGNED: DATE: