Linking Lives Eastbourne Volunteer

Volunteer application

Please fill out the form carefully.
Your Name*

PrefixFirst NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender*
Address*

Street Address

Street Address Line 2

TownCounty

Post Code
E-mail*
example@example.com
Mobile Number
Phone Number
Occupation
Languages
Church*
Ethnic origin*

White - BritishBritishAsianEuropeanChineseFilipinoIndianMixed Ethnic GroupWhite - Other
Allergies (including animals)
Please Check the Boxes Below to Help Us Know Which Tasks You Could Help With*

Home Visits - Regular visiting a Link Friend at homeTelephone Befriender - Regularly phoning a Link Friend at homeTelephone Plus - Regularly phoning a Link Friend at home, with occasional outingsAlongside - Going to specific activities with a Link Friendfor 3 - 6 months to facilitate them becoming part of a group / network
Would you be interested in befriending someone with anyof the following? You can tick more than one box (or none)

DementiaShortterm memory problemsLearningDisabilityMental Health Issues
Hobbies or interests that may help us in matching you to a Link Friend:
References

We require a reference from a leader in your church who has known you over 1 year. Please provide contact details below:
NameFirst Name*   Last Name*
Email   Email*
How do you know this person?   Type a label*
How long have you known this person?   Type a label*
Declarations

Please confirm your agreement or not with the following.
Confidentiality Agreement In the course of your befriending you may have access to confidential information and records about your Link Friends and sometimes other Volunteers. It is therefore vital that you treat all information about your Link Friends and other Volunteers as confidential.Our Link Friends and Volunteers must be able to have confidence that personal information will never be released.*

I agreeI do not agree
All the personal information we gather about you is necessary (a ‘legitimate interest’) for our organisation to work with you as a volunteer.(This is explained in more detail within our Privacy Policy which can be viewed at any time.) We are required to obtain your agreement to store your information and share it, only as necessary, within our team and/or to professional agencies to obtain relevant advice and support. I agree to my information being stored and shared securely by Linking Lives Eastbourne.*

I agreeI do not agree
I confirm the information in this application form to be correct and any misleading or falsification of information may be proper cause for rejection or termination of this placement.*

I agreeI do not agree
I confirm that I will complete all necessary paperwork and attend any required training as part of my preparation to become an active volunteer with Linking Lives Eastbourne.

I agreeI do not agree
I am happy to receive newsletters and updates about the general work of the charity.*

YesNo
Referee 1
Name   First Name   Last Name
Email
How do you know this person
Should be Empty:

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Volunteer application

References

Declarations