Health & Hope Local Church Champion Volunteer Application Form 2023

Health & Hope Local Church Champion Volunteer Application Form
Full Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Post Code
Daytime telephone number
Please enter a valid phone number.Format: (00000) 000-000.
Mobile number
Please enter a valid phone number.Format: (0000) 000-0000.
Are you over 18?

YesNo
What has prompted you to consider volunteering for us?
Please provide the name and full address of your church
What volunteer experience or skills do you have?
Criminal Convictions - Have you ever been charged with, cautioned or convicted in relation to any criminal offence not subject to DBS filtering rules or are you at present the subject of a criminal investigation/pending prosecution?

YesNo
If yes, please provide full details
Have you ever been the subject of a police investigation that didn’t lead to a criminal conviction?

YesNo
If yes, please provide full details
To your knowledge have you ever had any allegation made against you, which has been reported to, and investigated by, Social Services/Social Work Department (Children’s or Adult Social Care)?

YesNo
If yes, please provide full details
Has there ever been any cause for concern regarding your conduct with children, young people or vulnerable adults? Please include any disciplinary action taken by an employer in relation to your behaviour with adults.

YesNo
If yes, please provide full details
Declaration
I declare that the information given in this application is true . I understand that any offer of appointment and subsequent volunteering is subject to satisfactory reference and satisfactory disclosure from the Disclosure and Barring Service or Disclosure Scotland at the appropriate level, where this is a requirement of the role (if stated in the volunteer role description).
Please sign to confirm declaration
Please provide your church leader's contact details
Church leader's name
Church leader's email address
Church leader's telephone number
If you have any questions please telephone us on +44 (0)20 4558 6001 or email us on info@healthandhope.org.

Thank you!

Health & Hope team
Should be Empty:

Health & Hope Local Church Champion Volunteer Application Form

Declaration

Please provide your church leader's contact details