Volunteer Application Form

Confidential

Newry & Mourne ME/Fibromyalgia Support Group

9 Church View Close

Laurencetown

Craigavon

BT63 6DG

Please note that the information given below will be used to try to match potential volunteers to the most appropriate roles available at the time of application to volunteer with Newry & Mourne ME/Fibromyalgia Support Group.

Name: ……………………………………………………………………………………………………………………………….

Address: …………………………………………………………………………………………………………………………….

……………………………………………………………………………………Post Code: ……………………………………

Mobile: …………………………………………….. Email: …………………………………………………………………..

Please state the volunteer role you are interested in: ………………………………………………………..

Please note that all current volunteer positions require attendance 1st Tuesday of each month at support group meeting (Mourne Country Hotel, Belfast Road, Newry. 7pm – 10pm)

Would you be available to volunteer 3 hours per month, 1st Tuesday of each Month? ……………………………………………………………………………………......

Do you have any previous work experience, including voluntary work that would be relevant to this role? ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Do you have any hobbies or interests? ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Volunteer Application Form

Confidential

Newry & Mourne ME/Fibromyalgia Support Group

9 Church View Close

Laurencetown

Craigavon

BT63 6DG

Do you feel you could bring any special skills, or experience to our organisation? ......

Please provide the names and addresses of two people who we could contact for a reference. (Someone who is not a relative, and has known you for 2 years.)

  1. Name: ………………………………………………………………………………………………………………………..

Address: ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………...

Tel. No. : …………………………………………………………………………………………………………………....

  1. Name: ………………………………………………………………………………………………………………………..

Address: …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Tel. No. : …………………………………………………………………………………………………………………....

Signature: ……………………………………………………………………………………………………………………………

Date: ……………………………………………………………………………………………………………………………………

Thank you for your interest in becoming a volunteer, we will be in touch soon.Please return your completed form to the address above.

How Representative are we?

Newry & Mourne is committed to ensuring that its services are accessible to a diverse range of groups and people. We would therefore appreciate it if you could complete the following information for monitoring purposes only, and to help us gain an overview of the diversity of our volunteers. All information will be kept confidential and anonymous.

  1. Are You: Male Female
  1. Please indicate your age group :

18 – 25 26 – 39 40 – 59 60 +

  1. Do you consider yourself to have a disability? Yes No

A disability is defined as “a physical or mental impairment which has a substantial and long term adverse effect on a person’s ability to carry out normal day to day activities”

  1. What is your perceived religious affiliation?

I am a member of the Protestant Community

I am a member of the Roman Catholic Community

I am a member of neither the Protestant or Catholic Community

  1. Please indicate your ethnic background:

Bangladeshi Indian

Black – African Pakistani

Black – Caribbean Traveller

Black – Other White

Chinese Mixed Ethnicity

Other: ……………………………………………………………………………………………………………………………………

Thank You for completing this form.

Disclosure of criminal convictions

Applicant Name: ………………………………………………………………………………….

Volunteer role which you are applying for: ……………………………………………

Newry & Mourne ME/Fibromyalgia Support Group is committed to equality of opportunity for all applicants including those with criminal convictions. Information about criminal convictions is requested to assist the selection process and will be taken into account only when the conviction is considered relevant to the role.

Any disclosure will be seen in the context of the role description, the nature of the offence and the responsibility for the care of existing members/volunteers. The information provided may be assessed alongside normal selection criteria to determine suitability for the role of volunteer.

Please disclose as accurately as possible any criminal convictions except those which are considered “spent” under the Rehabilitation of Offenders (NI) Order 1978. If you have no convictions, state “none”

Date of conviction sentence / Offence

Disclosure of criminal convictions

Please provide any other information you feel may be of relevance such as:

  • The circumstances of the offence
  • A comment on the sentence received
  • Any relevant developments in your situation since then
  • Whether or not you feel the conviction has relevance to this role

I declare that any answers are complete and correct to the best of my knowledge.

SIGNED: ……………………………………………………………… DATE: ………………………………….

Volunteer Role Description

Role Title: …………………Volunteer Co-Ordinator…………………………………

Main purpose of role: ……To manage, recruit, and reward volunteers.

Questions/Issues / Notes
1 / What?
List all tasks in order of priority,
Identifying any client/user group the volunteer will be working with.
What might be difficult? / Managing volunteers, recruiting new volunteers, record keeping, arranging volunteer rewards, arranging volunteers for fundraising events. Keeping volunteer file updated.
2 / When?
Hours per week? Days, evenings, weekends? Short or long term? Set times or flexible. / Set time – 3 hours per month
1st Tuesday of each month.
7pm – 10pm
3 / Where?
Include everywhere the volunteer will be expected to go. / 12 Monthly meetings – Mourne Country Hotel, Belfast Road, Newry.
Occasionally other venues for fundraising events.
4 / With whom?
Will volunteer work alone or with other volunteers? / Must be able to work on own initiative, however support is always available. May be volunteering with Funding Officer.
5 / Support, supervision, training
Who will support /supervise the volunteer? / Volunteer will report to committee.
Initial supervision provided to update and maintain volunteer file, recruit and manage volunteers.
6 / Expenses
What expenses do you offer? / All out of pocket expenses as necessary
7 / What the role offers volunteers
Consider what the role offers / This role offers responsibility, data input, motivating people, leadership, recruiting new members, being a crucial part of organisation.

Volunteer Specification

Role Title: ………………Volunteer Co-Ordinator…………………….

Main purpose of role: ……………To manage, recruit and reward volunteers…

Questions/Issues / Notes
1 / What?
What skills, experience attitudes are needed? Physical requirements?
Dealing with difficult aspects. / Knowledge of team leading, record keeping, working with diverse groups, good communication/people skills
2 / When?
Maximum/minimum time commitment? How important is reliability? / 3 hours per month, extra hours when fundraising as necessary.
Attendance at most meetings preferred.
3 / Where?
Does volunteer need own transport/public transport?
Access requirements? / Location easily accessible, lifts with other members may be possible.
4 / With whom?
Will volunteer be working alone – in a team? Initiative? Team skills? / Initial supervision, own initiative to manage volunteers, may be volunteering alongside Funding Officer.
5 / Support, supervision, training
Can volunteer ask for support? Attendance at supervision or training? / Volunteers will always be supported by committee and members. Willingness towards training.
6 / Expenses
Does volunteer need to fill in forms to claim expenses? / Tally of volunteer hours necessary may need to fill in claims forms currently completed by committee.

SCIENTIFIC ADVISER: DR. VANCE SPENCE MEDICAL ADVISER: DR. WILLIAM WEIR PATRON: DR. ANNE MACINTYRE

NORTHERN IRELAND REGISTERED CHARITY NO. 100184