121 - Trustee Application Form

One to One Project Counselling Mentoring Group Work
TRUSTEE APPLICATION FORM
Name
Date of Birth

DayMonthYear
Date
Married/Single
If married, previous name
Address
Postcode
Home Tel No
Mobile No
Email
example@example.com
How long have you lived in this area?
Place of Birth
Please list your hobbies/interests
Are you, or have you ever been, a helper in Social Work or any other Voluntary Organisation? Please give details
Have you ever been convicted of a criminal offence? If so please give details. We are required to submit a police check with the Disclosures and Barring Service on behalf of all applicants.
If you have not been living at your present address for the last five years, please give details of previous addresses for the last five years, with dates. (Required for the police check).
Any other work or personal information which you feel would be useful
Signature

Clear
Date

DayMonthYear
Date
Should be Empty:

One to One Project Counselling Mentoring Group Work