LBM - Volunteer application form

Thank you for your interest in applying to volunteer.

Please complete the form below.

Leighton Buzzard Mencap guarantees that all information will be treated in the strictest of confidence as covered by the UK General Data Protection Regulation (UK GDPR) tailored by the Data Protection Act 2018.
PERSONAL INFORMATION
Name*

First nameSurname
Name of Guardian
Only complete if applicant is under 18
Date of Birth*

DayMonthYear
Date
Home Address*
Postcode*
Landline
Email Address*
example@example.com
Mobile*
Which group(s) are you interested in volunteering with? (tick all that apply) *

Opportunity Group (0-5)High 5s (8-18)Holiday Club (8-17)Friends Within (18+)Committee (Trustee)Fundraising
Where did you hear about Leighton Buzzard Mencap?*
Interests and hobbies*
Any voluntary and/or youth work experience*
What would you like to gain from volunteering with Leighton Buzzard Mencap?*
Is there any additional information you'd like to let us know about now?
PERSONAL REFERENCES

Please give details of two people (not relations) who can provide a character reference for you.*

	Reference 1	Reference 2
Name
Email Address
Phone Number
In what capacity do you know this person?

PERSONAL DISCLOSURE
Many of LB Mencap's volunteering opportunities will involve direct contact with children and vulnerable adults. As such, applications to volunteer are exempt from the Rehabilitation of Offenders Act 1974. This means that potential volunteers are required to declare their entire criminal record, including cautions, reprimands, final warnings and criminal convictions categorised as 'spent' under the above legislation.

If you have a criminal record, this will not necessarily prevent you from volunteering. However, because of the vulnerability of the people we work with, we reserve the right to conduct checks as necessary.

All volunteers will be subject to an enhanced DBS check.
Have you ever been convicted at a Court or Cautioned by the Police for any offence?*

YesNo
If yes, please give details, stating date(s) and nature of offence(s).
LEIGHTON BUZZARD MENCAP MEMBERSHIP
I wish to become a member of Leighton Buzzard Mencap and I consent to the Society contacting me from time to time in connection with my membership and to keep me aware of the Society's activities and services.

We promise that we will only use your data to keep in touch with you and to inform you about the work of Leighton Buzzard Mencap. We will keep your data safe and will not pass it on to other organisations, and will modify or delete it at your request or if you cease to be a member of the Society.
If you wish to become a member of Leighton Buzzard Mencap, please indicate your preferred method(s) of communication by marking a cross in the relevant box(es). You do not need to become a member if you do not want to; this will not affect your application to volunteer.

EmailPostTelephone
DECLARATION
By signing below, I declare that the information contained in this application is correct.
Signed*

Clear
Date*

DayMonthYear
Leighton Buzzard Mencap documents its groups and activities through photos and/or videos for publicity and promotional purposes, such as for use on our website, social media, local press and printed paperwork. Please advise us if you do not wish your photograph likeness in videos to be used.
Please verify that you are human*
Leighton Buzzard Mencap / Registered Charity No. 259104

www.lbmencap.org / 07934 916 422 / info@lbmencap.org

Facebook / Instagram - @lbmencap
Should be Empty:

Now create your own Jotform - It's free!Create your own Jotform

PERSONAL INFORMATION

PERSONAL REFERENCES

PERSONAL DISCLOSURE

LEIGHTON BUZZARD MENCAP MEMBERSHIP

DECLARATION