IM2C Volunteer Application Form

Include Me 2 Club SCIO - Volunteer Application Form
Welcome to Include Me 2 Club SCIO. This volunteer application form is designed to give us as much detail and information to support you on your volunteering journey.

As Volunteer Friendly Award recipients we hold a supported process for volunteers to enable them to get the best experience from their volunteering efforts.

It takes you through the process of identifying:
- About You
- Services and Activities
- Understanding your interests, aspirations and availability
Please take the time and detail as much information you have, can input and help us get the best picture of your needs and your require requirements

Thank You

Personal Details
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityLocal Authority

Post Code
Contact Phone Number*
Contact Mobile Phone Number*
Email*
example@example.com
Date of Birth*

DayMonthYear
Date
Age*
How do you identify yourself?*
Do you have any communication needs?*
How can we best communicate with you?
What way can we best communicate with you?

TelephoneTextEmailLetterOther
How will you get to the volunteer location

DrivePublic TransportParents/Guardian will drop meOther
What size of T-Shirt do you need?
What size of Hoody do you need?

Emergency Contact Information
Do you have a specific medical conditions or barriers to volunteering we should know about to help you in your role?*
Emergency Contact*

First NameLast Name
Relationship*
eg, parent/guardian, carer
Emergency Contact Email*
example@example.com
Emergency Contact Phone Number*
Emergency Contact Mobile Number*

PVG Scheme
The volunteering position that you have applied for is exempt from the Rehabilitation of Offenders Act 1974 by the Exclusions and Exceptions Scotland Order 2003 and the Police Act 1997 (Criminal Records) (Scotland) Regulations 2006. You are therefore required to disclose all convictions (spent and unspent), cautions, and any relevant non-conviction information.

Should you be appointed for the position applied for you will also be required to join the Protecting Vulnerable Groups (PVG) Scheme or provide us with access to your PVG Scheme Record/Updates, if you are already a member of the scheme.

NOTE: The information given in this form will be treated in the strictest confidence.
Are you a member of the PVG Scheme?*

YesNoUnsureOther
If Yes, please tell us your 16 Digit PVG Number
Please upload a copy of your PVG Number

Cancelof
Please upload a copy of your Driving License, Provisional, Passport or Photographic Identification with your date of birth information or Birth Certificate*

Cancelof
Please upload a copy of your proof of address, for example a bank statement, household bill, benefits letter or council tax/housing provider letter addressed to you. *

Cancelof
Section 1 – Convictions and cautions
1. Do you have any convictions, cautions or charges that you wish to declare as part of your recruitment process? If YES, please answer the following questions, If NO, please complete and sign your declaration. *
2. Please give the date and details of the conviction(s) that you were charged with, the sentence that you received and the court where your conviction(s) was heard.
3. Please give details of the reasons and circumstances that lead to your offence(s)
4. Please give details of how you completed the sentence imposed, (for example did you pay your fine as required, what conditions were attached to your probation/community service/supervised attendance order, did you comply with the requirements of your order/custodial sentence etc.
5. What have you learned from the experience?
Section 2 : Please details any non-conviction information that you think is relevant:
Declaration: I certify that all information contained in this form is true and correct to the best of my knowledge and realise that false information or omissions may lead to dismissal
Signature*

Clear

Date completed*

DayMonthYear
Date
Signature*

Clear
Please verify that you are human*
Should be Empty:

	Mon	Tue	Wed	Thur	Fri	Sat	Sun
Morning
Afternoon
Evening

Include Me 2 Club SCIO - Volunteer Application Form

Personal Details

Volunteering Interests

Emergency Contact Information

PVG Scheme

Section 1 – Convictions and cautions