Age UK Westminster Volunteer Application Form
Please fill in ALL sections of this form. Failure to fill out all sections may lead to a delay in the volunteer recruitment process.
Personal details
Forename(s):
First name (e.g. Mike)
Surname:
Surname (e.g. Smith)
E-mail:
example@example.com
Address:
*
Address Line 1
Address Line 2
Town (e.g. London)
County (e.g. Greater london)
Postcode
Please select your postal district:
*
Please Select
Abbey Road
Bayswater
Bryanston & Dorset Square
Church Street
Churchill
Harrow Road
Hyde Park
Knightsbridge & Belgravia
Lancaster Gate
Little Venice
Maida Vale
Marylebone
Queen's Park
Regent's Park
St. James's
Tachbrook
Vincent Square
Warwick
West End
Westbourne
I live outside of Westminster
Other/I prefer not to say (withheld)
The postal districts align to electoral areas within Westminster. If you live outside of Westminster, please mark the option 'I live outside of Westminster'
Telephone (home):
-
Area Code
Phone Number
Telephone (work):
-
Area Code
Phone Number
Mobile phone:
-
Area Code
Phone Number
Preferred Method of Contact:
*
Please Select
Home phone
Work phone
Mobile phone
E-mail
Volunteer roles
Please select all of the volunteer roles that interest you. Some opportunities may require you to already have specific skills while other may not currently be available:
*
Charity Shop (Mon-Sat)
Fundraising (Office hours only)
Befriending Visits
Telephone Befriending
Community Events/Outreach
Group Digital IT Support (Office hours only)
One-To-One Digital IT Support (Office hours only)
Project Admin Support (Office hours only)
Telephone Enquiry & Signposting Volunteer (Office hours only 10am - 2pm)
Information & Advice - In the community (Office hours only)
Dementia Support
Other
If other, please specify the role you'd like to volunteer for:
Availability
Please provide details around your availability to volunteer with us:
Days of week:
*
Weekdays (Morning)
Weekdays (Afternoon)
Weekdays (Evening)
Weekends (Morning)
Weekends (Afternoon)
Weekends (Evening)
Length of commitment:
*
1-2 hours (per day)
2-4 hours (per day)
4-7 hours (per day)
All day
Availability Frequency:
*
Everyday
2-3 times a week
Once a week
Every 2 weeks
Once a month
Every 2 months
Every 6 months
Every 6months +
How did you hear about us?
Please select how you heard about us at Age UK Westminster (AUKW):
Please Select
AUKW website
AUK National Website
Volunteering Recruitment Organisation
Flyer/Leaflet/AUKW Newsletter
Online Advert
University/College
Community Event
AUKW Client/Volunteer
Other
If other, please specify how you heard about us at AUKW:
Employment history
Please attach your CV to your application. Alternatively, please provide details of all previous employment, most recent first.
Please attach a copy of your CV if available
Browse Files
Drag and drop files here
Choose a file
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of
Add an employment (most recent)
Employment 1
Please provide details of your most recent employment, if applicable. Alternatively, please leave blank:
Job title
Name of Employer
Main responsibilities
Start date
-
Day
-
Month
Year
Date
Ending date
-
Month
-
Day
Year
Date
Reason for leaving
Add another employment (if applicable)
Employment 2
Please provide details around your employment which follows before the employment provided above, if applicable. Alternatively, please leave blank:
Job title
Name of Employer
Main responsibilities
Start date
-
Day
-
Month
Year
Date
Ending date
-
Month
-
Day
Year
Date
Reason for leaving
Add another employment (if applicable)
Employment 3
Please provide details around your employment which follows before the employment provided above, if applicable. Alternatively, please leave blank:
Job title
Name of Employer
Main responsibilities
Start date
-
Day
-
Month
Year
Date
Ending date
-
Month
-
Day
Year
Date
Reason for leaving
Add another employment (if applicable)
Employment 4
Please provide details around your employment which follows before the employment provided above, if applicable. Alternatively, please leave blank:
Job title
Name of Employer
Main responsibilities
Start date
-
Day
-
Month
Year
Date
Ending date
-
Month
-
Day
Year
Date
Reason for leaving
Skills
Please tell us of any relevant skills you may have for the position(s) you are applying for (e.g. retail, administration, accounting, debt advice, etc):
*
What are your other interests/hobbies?
*
Do you speak any languages other than English? If so, please provide details and level of proficiency:
E.g. Spanish (fluent)
Please tell us about any qualifications you may have (e.g. certificate, degrees, diplomas, GCSEs, A Levels, NVQs etc)
*
Have you ever been convicted of a crime? If yes, please give details:
*
Is there anything in your medical history or disability that may affect your ability to volunteer? If yes, please give details including any reasonable adjustments required to assist you with the recruitment process and volunteering opportunity:
*
Please use this space to write any other information which you feel may be relevant to the positions you are applying for:
Are you legally entitled to work/volunteer in the UK?
*
Please Select
Yes
No
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References
Please provide two references. One needs to be formal (i.e. a current or previous employer, teacher, lecturer) who has known you for at least one year. The other reference can be a personal friend. Please do not use a family member, partner or spouse.
Reference 1 (formal reference)
Please provide details of referee 1:
Name
*
Forename(s):
Surname:
Email
example@example.com
Address:
*
Address Line 1
Address Line 2
Town (e.g. London)
County (e.g. Greater london)
Postcode
Daytime telephone number:
*
-
Area Code
Phone Number
Relationship to you:
*
E.g. Former line manager
Reference 2 (formal or personal reference)
Please provide details of referee 2:
Name
*
Forename(s):
Surname:
Email
example@example.com
Address:
*
Address Line 1
Address Line 2
Town (e.g. London)
County (e.g. Greater london)
Postcode
Daytime telephone number:
*
-
Area Code
Phone Number
Relationship to you:
*
E.g. Former line manager
Emergency contact details
Please provide contact details of whom we should contact if an emergency situation were to arise:
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Relationship to you:
*
E.g. Sibling
Please confirm that you have received consent to supply details of your emergency contact:
*
Yes, I have received their consent
Doctor details
Please provide details of your GP:
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Address:
*
Address Line 1
Address Line 2
Town (e.g. London)
County (e.g. Greater london)
Postcode
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Equality & Diversity Monitoring
Please select the option that describes you best:
To which of these groups do you consider you belong?
White British
White Scottish
White English
White Welsh
White Other
Mixed - White & Black Caribbean
Mixed - White & Asian
Mixed - White & Black African
Mixed - Other
Asian - Asian British
Asian - Asian Scottish
Asian - Indian
Asian - Bangladeshi
Asian - English
Asian - Welsh
Asian - Pakistani
Asian - Other
Black - Black British
Black - Black Scottish
Black - African
Black - Black English
Black - Black Welsh
Black - Caribbean
Black - Other
Chinese - Chinese British
Chinese - Chinese Scottish
Chinese - Chinese English
Chinese - Chinese Welsh
Chinese - Chinese
Chinese - Other
Arab - Middle Eastern
Arab - North African
Other
Prefer not to say
If other, please note to which group you consider to belong:
Gender
Please Select
Male
Female
Transgender
Prefer not to say
How would you describe your religion or belief?
Please Select
Buddhist
Muslim
Christian (all denominations)
Sikh
Hindu
Jewish
No religion
Other
Prefer not to say
How would you describe your sexual orientation?
Please Select
Bisexual
Gay man
Gay woman/lesbian
Heterosexual/straight
Other
Prefer not to say
Date of birth:
-
Day
-
Month
Year
Date
Have you ever been convicted of a criminal offence? If yes, please ensure you have provided details on the application form (Skills section)
Please Select
Yes
No
Do you consider yourself to have a disability? If yes, please ensure you have provided details on the application form (Skills section) including any reasonable adjustment required to assist you with the recruitment process
Please Select
Yes
No
The Disability Discrimination Act (1995) covers any individual who has a physical or mental impairment which has substantial long-term adverse effect on his or her ability to carry out normal day to day activities. You do not need to be registered disabled to be covered by the Act.
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Relationship to Age UK Westminster
Are you related to any Age UK Westminster staff, volunteers or members of the executive Committee? Please note, relationships include blood, lawful or close personal (e.g. partner)
*
Yes
No
If yes, please state their name and the relationship:
E.g. Mike Smith (Age UK Westminster volunteer who is my husband)
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Declaration(s)
Here at Age UK Westminster, we take your privacy seriously and will only use your personal information to administer your account and to provide the products and services you have requested from us. However, from time to time we would like to contact you with details of other services we provide, and information about any events or campaigns that we are running. If you consent to us contacting you for this purpose, please select how you would like us to contact you:
*
Post
Email
Telephone
Text message
No, I do not wish to be contacted
As a volunteer with Age UK Westminster, there may be occasions when we take photographs or video of you, which may include you for the purpose as stated below. Please tick the following boxes if you consent to us using your photographs or video for the purpose stated:
*
I give my consent for Age UK Westminster to take photographs or video of me as stated. I understand that the resulting imagery will be used to publicise Age UK Westminster's events, including our website, social media pages and newsletters
I give consent for Age UK Westminster to share these photographs or videos with funders and potential funders as part of application and/or monitoring for funding Age UK Westminster has recevied from them.
I do not give my consent for photographs or videos of me to be used for any purposes.
Please sign as declaration that the information on this form is true and correct to the best of my knowledge:
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Please verify that you are human
*
Submit
Should be Empty: