Form
Women's Health Matters Volunteer Application Form
If you require any support completing this form, or you would prefer to complete it over the phone, please contact the WHM office on 0113 276 2851
Application for the post of:
*
Please Select
Administration Support Worker
Social Media Communications Ambassador
Rainbow Hearts Group Support Worker
Creche Support Worker
Other
Where did you hear about this volunteering opportunity?
Personal Details
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
City
Post Code
Phone Number
*
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Email
example@example.com
Availability
Date Available From:
-
Day
-
Month
Year
Date
Days and Hours Available:
*
Monday
Tuesday
Wednesday
Thursday
Friday
AM
PM
References
Please give contact details of two people, whose consent you have to share their details, we can approach for a professional or personal reference.
*
First Referee
Second Referee
Name
Relationship to you
Telephone
Email
Additional Information
Please explain why you are interested in volunteering with Women's Health Matters. Please also describe your attitude, skills and any experiences relevant to the role you are interested in.
*
Reasonable Adjustment
If you consider yourself to have a disability as defined by the Equality Act and believe that you may require reasonable adjustments to be made to the application and/or interview process, then please indicate this below. If you have indicated that you would like reasonable adjustments to be considered as part of the process, then we will contact you to discuss this futher.
I would like to receive a call to discuss reasonable adjustments to the application process
*
Yes
No
Declarations
I confirm that the information I have given on this form is correct and complete and that I understand misleading statements may be sufficient grounds for dismissal. Due to data protection requirements we need your permission to process and retain information you have provided on this form in relation to this recruitment process. Please sign here if you are happy for us to do so.
Signature
*
Clear
Submit
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