Apply to volunteer

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Application Details

Date of Application

How did you hear about Circles South West?

Your Personal Information

Your Name*

First Names Surname

Date of Birth*

Home Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Email Address*

Telephone Number*

Please indicate the areas in which you able to volunteer*

Please indicate the days/times you may be available to volunteer*

Monday

Daytime

Evening

Tuesday

Daytime

Evening

Wednesday

Daytime

Evening

Thursday

Daytime

Evening

Friday

Daytime

Evening

This opportunity requires a 12 month commitment. Are you available for a minimum of 12 months?*

Yes

Please give brief information about your education, employment and voluntary experience**

Please describe any skills you would bring to the role**

Why would you like to volunteer with Circles South West?**

Is there anything further you would like us to be aware of?**

Do you consider yourself to have a disability?**

Yes

If yes, please provide details of any special requirements*

Have you lived outside of the UK? (One year plus)

Yes

Do you have employment rights to work in the UK?*

Yes

Do you have a criminal record, including matters ‘spent’ under the Rehabilitation of Offenders Act 1974?*

Yes

Are you barred from working with children or vulnerable adults?*

Yes

Have any allegations of inappropriate or harmful behaviour towards children been recorded against you or have you had any prior involvement with Social Services relating to the care of your own or other children?*

If yes, please provide details or discuss with the volunteer coordinator before proceeding.

Do you have a current Enhanced DBS (Disclosure & Barring Service) Certificate for the Adult and Child Work Force that is registered on the Government’s DBS Update Service?*

Yes

If yes, please provide your certificate number

Have you received MoJ Enhanced Level 1 (or LEAP) Vetting clearance in the last 5 years?*

Yes

If yes, please provide date of clearance and the organisation you worked for

References

PLEASE PROVIDE DETAILS OF TWO REFEREES WHO HAVE KNOWN YOU FOR MORE THAN 2 YEARS. Your PROFESSIONAL referee must be your current or most recent employer or university lecturer.Your PERSONAL referee cannot be a family member or your partner.

Referee 1 (Professional)

Name*

Relationship to you*

Email Address*

Telephone

Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Referee 2 (Personal)

Name*

Relationship to you*

Email Address*

Telephone

Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

GDPR Check*

Circles South West will hold your application form securely, in accordance with our GDPR data protection policy, for the entirety of your time as a volunteer and up to one year beyond that to allow you to seek references from us. If you are unsuccessful or choose to terminate your volunteer role we shall hold your application for 6 months before it is securely destroyed.*

Please check the box to show you understand and accept this.

The information that you have supplied will be used by Circles South West for administrative and statistical purposes and will be processed in accordance with all current Data Protection legislation. The Data Controller under the General Data Protection Regulation (GDPR) is Circles South West. A Privacy Notice can be found at www.circles-southwest.org.uk/privacy-policy. For impartial advice on Data Protection please contact the Information Commissioner’s Office on 01625 545745 or visit www.ico.org.uk.

Safeguarding is Circles South West’s priority. We expect staff, volunteers and stakeholders to share this commitment.

Equal Opportunities Monitoring

Circles South West is committed to promoting equal opportunities. You are not required to complete this section but the information you provide helps us to provide for the needs of our diverse Volunteers and ensure that our policies, practices and environment are equitable. The data collected are confidential to Circles South West and Circles UK and will be kept in compliance with the Data Protection Act.

Date

Disability

Under the Disability Discrimination Act, a disability is defined as a physical, sensory or mental impairment which has, or had, a substantial and long-term effect on a person's ability to carry out normal day-to-day activities.Disability is recorded on the basis of your own self-assessment. If you do consider yourself to be disabled, please tick the option(s) below that best describes your disability. If you are not disabled, leave this blank.

Mental health condition (such as depression or schizophrenia

Cognitive impairment (such as autistic spectrum disorder or resulting from head injury)

Deaf or serious hearing impairment

Long-standing illness or health condition (such as cancer, diabetes HIV, chronic heart disease, or epilepsy)

Blind or serious visual impairment

General learning disability (such as Down's syndrome)

Physical impairment or mobility issues (such as difficulty using arms or using a wheelchair or crutches)

Cognitive impairment (such as autistic spectrum disorder or resulting from head injury)

Other

Other Disability

Ethnic Group

The options reflect the 2001 Census of Population ethnicity classifications used throughout the UK and so allows comparative statistics to be derived. What is your ethnic origin? Select the most appropriate option.

Sexuality

What is your sexuality? Select the most appropriate option.

Heterosexual / straight

Gay man

Gay woman / Lesbian

Bi-sexual

Other

Prefer not to say

Other

Employment

What is your employment status? Select the most appropriate option.

Employed full-time

Employed part-time

Retired

Student

Self-employed

Unemployed

Religion or belief

What is your employment status? Select the most appropriate option.

I have no religion or belief

Prefer not to say

Other

Note that DBS and MoJ vetting will only be progressed when you are accepted for volunteer training.

Application Details

Your Personal Information

Please indicate the days/times you may be available to volunteer*

References

Referee 1 (Professional)

Referee 2 (Personal)

Equal Opportunities Monitoring

Our Funders