Skills & Wellbeing - Application Form

  • Skills & Wellbeing - Application Form

    Thank you for your interest in joining one of our groups at St Werburghs City Farm. To get started, please fill in and submit the form below. The form has three sections: Personal Details, Health, and Equal Opportunities. If you’re not able to answer a question, just write “N/A” in the box.

  • This application is to join one of our friendly, supportive group sessions. If you’re looking for other ways to get involved, you can also complete our volunteer form under “Get Involved” on our website.

  • Which volunteering opportunities are you most interested in?*

  • Please have a look at our website for other projects and ways to get involved. You can also contact office@swcityfarm.co.uk for any questions.

  • Personal Details

  • Date of birth*
     - -

  •
  • Do you have a Keyworker?*
  • Level of spoken English*
  • Level of reading/writing English*
  • Which days are you available to volunteer?*
  • Will you be completing a work volunteer placement by volunteering at the Farm, whether that’s a one-off or long-term placement?*

  • Health

    The questions on the following page are about your health. It is important that you answer these in as much detail as you can, this helps us to make your time as comfortable as possible whilst on the farm and ensure your safety.
  • Do you consider yourself to have, or be recovering from, mental ill health?*
  • Do you consider yourself to have a learning difficulty or disability?*
  • Do you consider yourself to have, or be recovering from, a physical disability, condition or illness?**
  • Do you have a current/recent problematic drug/alcohol use?*
  • Are you currently taking and medication that you believe farm staff need to aware of and may affect your volunteer placement at the farm?*

  • Rehabilitation of Offenders Act 1974

    SWCF are required to take certain safeguards to protect vulnerable groups, and therefore must ask you for details of any unspent criminal convictions. Any information given will be treated in strict confidence and used only in connection with this application. A criminal record is not necessarily a barrier to volunteering. If you do have a criminal record, your suitability for a volunteering role will be assessed according to your record's relevance to the role. Dismissal from a voluntary post may result if it is discovered that previous convictions were not disclosed.

  • Do you have any convictions or conditional cautions which are currently unspent under the Rehabilitation of Offenders Act 1974 [You do not need to disclose anything that is ‘spent’ at this time]?*

  • Check whether your conviction or caution is spent here: www.disclosurecalculator.org.uk and read guidance at hub.unlock.org.uk/roa

  • Are you currently under probation supervision?*

  • Declaration

    I declare that to the best of my knowledge the information provided is accurate and I give permission for SWCF to contact the police/probation if they deem it appropriate.

  • Do you give SWCF permission to take photographs or videos of you with the intention to use in publicity materials, social media sites, website, reporting to funders and other carefully selected third parties such as newspapers, and magazine articles to help promote the farm?*
  • How did you hear about us?

  • Equal Opportunities Monitoring

    The questions on the following page are equal opportunities. SWCF is committed to equal opportunities for all. Please help us monitor the implementation of our policy by completing the following. All information is treated as confidential and will only be used for statistical monitoring.
  • Gender*
  • Is the gender you identify with the same as your gender registered at birth?*
  • What is your age?*
  • What is your ethnicity? Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong. Please tick the appropriate box*
  • What are your religious beliefs?*
  • Do you consider yourself to have a disability or health condition?*
  • What is your sexual orientation?*
  • Do you consider yourself to have experienced inequality, marginalisation or social exclusion?*
  • Do you consider yourself to have experienced mental ill health (depression, anxiety, OCD, eating disorder) for 12 months or more in the past 10 years?*

  • By submitting this form you agree that all information you provided is true and correct.

  • Should be Empty: