IV/Mentor Applications

Volunteer Application Form

We are thrilled you are interested in helping to make a difference to the lives of children and the community!
Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Address *
Date of Birth

MonthDayYear
Date
Do you hold a driving licence and have access to a vehicle?*

Yes I doNo I do not
Do you have a preference of volunteering as a mentor or as an Independent Visitor? Please note you must be 18+ to volunteer as a mentor or 21+ to volunteer as a befriender.

MentorIndependent Visitor ('befriender')I do not have a preference
Have you or any of your family ever accessed any services provided by Changing Futures or Headland Futures, including Tees Valley Mediation? If yes, please tell us which service and who you worked with?*
Are there any adjustments that may be required to be made for you at interview? If yes, please give details:
Please let us know your availability for volunteering - days/times (approximate hours per fortnight):*
Please let us know your reasons for wanting to be a volunteer:*
Please tell us any relevant skills and/or experiences you may have: *

Please provide at least 5 years employment or educational history:*

	Company or educational institution	Date from/until	Company/educational institution address	Role Held
1
2
3
4
5

Please provide reasons for any gaps in employment: *
References

Please note we cannot accept friends or family as references. Due to the sensitive nature of our volunteer roles and organisations, we have safer recruitment procedures in place. As per our volunteering policy, we will be unable to accept volunteers without doing reference checks. Referees can include current/past: Employers, Education - teachers/lectures/tutors etc, Supervisors from previous volunteering, Any extra curricular leaders (e.g. scouts/church/sport club, etc). You must provide a method of contact for 2 referees:
Reference 1 - Name*

First NameLast Name
Reference 1 - Relationship to you and organisation/educational institution:*
Reference 1 - Phone Number*
Please enter a valid phone number.
Reference 1 - Email address*
example@example.com
Reference 2 - Name*

First NameLast Name
Reference 2 - Relationship to you and organisation/educational institution:*
Reference 2 - Phone Number*
Please enter a valid phone number.
Reference 2 - Email address*
example@example.com
If you are unable to provide 2 or more references, please provide any reasons.
Protecting Children, Young People and Adults

We need and want to keep vulnerable people and children safe. Because of this, we have to ask some personal questions about criminal convictions (spent and unspent) and cauations, or pending or ongoing court cases. All paid and unpaid roles are exempt from the Rehabilitation of Offenders Act 1974. The amendements of the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are 'protected' and are now subject to disclosure to employers, and cannot be taken into account.

Having a criminal record does not necessarily stop people helping out with Changing Futures NE. We will look into each case individually.

If you have any offences against children or vulnerable adults, or aren't honest with us on the form, you won't be able to volunteer with us. If you are barred from working with children or vulnerable adults and make an application to use, we will report this to the police.

If you have ever been convicted of a criminal offence, caustioned or reprimanded or given a final warning by the police or have any court cases pending, please give details below including dates of offences, sentences, cautionsm, reprimands, final warnings and details of court cases pending unless these are "protected" as definded by the Rehabilitation of Offenders Act 1974 (Exceptions) order 1975 (as amended in 2013).
Protecting Children, Young People and Adults. Do you have any Criminal Convictions?*
If you have responded Yes to the above question, please describe the offence and date of conviction, if you responded No, please enter No*
Declaration of Consent

GDPR: I understand and agree my information will be collected for the purpose stated and understand how CFNE will collect, process and store my personal information.

Personal Information: Any personal information you supply by submitting this form will be used solely for the purpose it was intended for. We will not be passing your information onto a third party or using your email for any additional marketing.

Police Check: I understand that it is an offence for a person disqualified from working with children, young people or vulnerable adults to apply for this role, and the police will be contacted if believed an offence has been committed.

GDPR Agreement: I understand and agree my information will be collected for the purpose stated and understand how CFNE will collect, process and store my personal information.

Enhanced Disclosures: I agree to submit to an Enhanced Disclosure and Baring Service Check if I am successful in my application. I understand that any offer of a volunteering role will be conditional on the check not identifying information which CFNE believes would make me unsuitable as a volunteer.

Reference Checks: I agree to references being taken up CFNE, and to provide proof of ID and address when asked.
Should be Empty:

Volunteer Application Form

References