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REF: P1 -KS262 / 1              (PLEASE PRINT BLOCK CAPITALS)

“IT CAN HELP” NETWORK VOLUNTEER APPLICATION FORM

 
Full name:
 
 

                             

 
 
YES/NO
YES/NO
YES/NO
eg BCS:
Address:

Post Code:
Tel Number:
Other method of contact
Valid Driving Licence
Disabled yourself?
Could you visit clients
Memberships

     COMPUTER HARDWARE & SOFTWARE EXPERIENCE (i.e. PC, Mac, Windows, MS Office, Lotus,  ETC.)?:

:p>
 
 
 
 
 

                    ANY FURTHER EXPERIENCE THAT YOU FEEL MIGHT BE AN ADVANTAGE:­

 
 
 
 

               NAMES  AND  ADDRESSES  OF  TWO  REFEREE’S    (NOT RELATED TO YOURSELF) :

Name:

 Name:
Address: Address:
   
   
   
 

Because of the nature of the type of work, involving contact with vulnerable people, you are required by the Rehabilitation of Offenders Act 1974, to declare all convictions, including spent convictions.  If this applies to you, please give details here (having a conviction will not necessarily prevent you becoming a volunteer):
 
 
 

I certify that the information provided above is correct.

Signed:………………………………………Date……………………………………

  :p>

 

 

 

 

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