Women's Health Matters Volunteer Application Form
If you require support filling this form, would prefer to complete it over the phone or would like a paper copy, please contact the WHM office on 0113 276 2851
Application for the post of:
Please Select
Rainbow Hearts Group Support Worker
Other
Where did you hear about this volunteering opportunity?
Personal Details
Name
*
First Name
Last Name
Date Of Birth
*
/
Day
/
Month
Year
Date
Address
Street Address
Street Address Line 2
City
Post Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Availability
When can you start volunteering?
*
-
Day
-
Month
Year
Date
What days are you available to volunteer?
*
Monday
Tuesday
Wednesday
Thursday
Friday
AM
PM
Additional Information
Please explain why you are interested in volunteering with Women's Health Matters. Please also describe your attitude, skills and any experience (including life and work experience) relevant to the role you are interested in.
*
Please provide contact details of two people we can approach for a professional or personal reference
*
First Reference
Second reference
Name
Relationship to you
Telephone
Email
Reasonable adjustments
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 further.
I would like to receive a call to discuss reasonable adjustments
Yes
No
Declarations
I confirm that the information I have given on this form is correct and complete to the best of my knowledge. I understand that misleading or incorrect statements may be sufficient grounds for dismissal. Due to data protection requirement we need your permission to process and retain information you have provided on this form in relation to this volunteer recruitment process. Please sign here if you are happy for us to do so.
Signature
Submit
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