Volunteering Application Form

Please fill in all the information on the application form before sending it.

Title
MrMrsMissMsDr

Full Name

Address

Daytime Telephone Number

Evening Telephone Number

Email

Date of Birth

Do you possess a Full, Clean and Current Driving License?
YesNo

Are you a car owner?
YesNo

Are you currently?
EmployedStudentUnemployedOther

What personal qualities, skills and experience could you bring?

First Reference?

Please provide the Names of two referees who are well known to you but exclude family relatives, who we may contact about your suitability to volunteer at Age Connects Torfaen.

Name:

Address:

Telephone:

Second Reference?

Name:

Address:

Telephone:

Have you ever been convicted of a criminal offence?

All applicants may be subject to a disclosure check by the Criminal Records Bureau.

YesNo

Please indicate the areas of volunteering that are of interest to you?
Reception/HospitalityKitchen WorkInformation/AwarenessBenefit AdviceDay Activities Support (ie. Music, Art, Quizes)Caretaker SupportAdministration/IT/Computer Data/Office SkillsPromotion/Fundraising/Open DaysShopping/Window DisplayBefriending

Your availability?
WeeklyMonthlyOccasionallyFlexibleTimes to suitVolunteer Bank

How did you hear of the volunteering opportunity?

Consent?

To assist with your enquiry, we require consent to store information about you, the law states that we must receive your consent to do this. All details will be treated confidentially. Please read the sentence below, if you consent tick the box. I give my consent to Age Connects Torfaen to record personal information about myself and use images and videos of myself for fundraising and publicity purposes.

YesNo