Membership Application Form

EMCBP - MEMBERSHIP APPLICATION FORM
Trustees:
- President - Nigel Anderson - BA(Hons)
- Secretary - Sue Steventon
- Treasurer - Jim Strudwick - MSc FRSA
- Chair - Dr. John Wm.Stephens - CBE FRSA
- Jayne Bailey
- Angela Cartledge
- John Fletcher - Dipi Csci FICorr
- David Gardner
- Peter Marlor
- Keith Glover
  
  EMCBP is a Charitable Incorporated Organisation Registered Charity No. 1155976 Established 1994
  For general enquiries: E-mail: emcbp@tiscali.co.uk
  Web site: www.emcbp.org.uk
  Online Bookings: https://www.emcbp.org.uk/Bookings
  Telephone: 07503 145146
  
  Thank you for your interest in
  The East Manchester Community Boat Project.
Name*

First NameSurname
Maiden or other surnames if applicable
Title (Mr/Mrs/Ms/other)
Age Range:-*

18 - 2425 - 3435 - 4445 - 5455 - 6465+
Address*

Street Address

Street Address Line 2

CityCounty

Post Code
Previous address (if less than 3 years at current address)
Email Address*
example@example.com
Telephone Number(Landline)

Area CodePhone Number
Mobile Telephone Number
Qualifications
Career and Background
Do you have any previous Volunteering experience?
What skills do you think you bring to the project?
If you have any other skills, knowledge or experience that may be beneficial to EMCBP please let us know. We are particularly interested in the following; First Aid, Health & Safety, Safeguarding, Legal, Finance & Accounting, Information Technology & Fundraising.
What are your Hobbies and Interests?
Please let us know if you have any prior boating experience and/or relevant qualifications
Please let us know if you have any unspent criminal convictions
Health - Working on the boat can be physically demanding. Please write here any health issues you think we should be aware of. This will remain confidential at this stage (other than Trustees). If we need to disclose any health information to anyone else (i.e. skippers) we will discuss this with you.
Please let us know how you would like to help the project: (please tick all the relevant boxes and don't worry - where necessary, full training will be provided)

SkipperInformation OfficerFund RaisingCrewOffice AdministrationMaintenance
References:-

Insert Name plus Email address and/or Postal Address

Reference 1:
Name*

First NameLast Name
Email*
example@example.com
Address

Street Address

Street Address Line 2

Town/City

Post Code
Occupation
Reference 2:
Name*

First NameLast Name
Email*
example@example.com
Address

Street Address

Street Address Line 2

Town/City

Post Code
Occupation
In signing this application, I hereby agree to:
- uphold East Manchester Community Boat Project's (EMCBP) Constitution
- give your permission for EMCBP to store your name and address in accordance with the Data Protection Acts 1998 and 2003
- abide by EMCBP's health and safety rules and regulations
- follow the directives laid down by EMCBP's policy documents
- abide by any directives set by EMCBP's trustee committee
- submit to 2 reference checks (one of whom may be a current member of EMCBP but must not be a family member)
- attend an informal interview with trustees
- await the outcome and approval from EMCBP trustees before working with passenger groups.
Please provide the name, postal address or email address and occupation of two references (not family) who would be willing to provide a reference as to your suitability to become a volunteer with EMCBP. A reference request will ask for an opinion as to your suitability to work with children and vulnerable adults and ask the reference provider to confirm (to the best of their knowledge) whether or not you have any criminal convictions.

N.B. Please note - the reference request will be emailed to the referee, unless you request otherwise.
SIGNED*

Clear
DATED*

DayMonthYear
Office address: EMCBP, Portland Basin Marina, Lower Alma Street, Dukinfield, Cheshire. SK16 4SQ
Secretary: EMCBP, 144 Sheffield Road, Hyde, Cheshire. SK14 2PJ

Elcometer Limited and Topping Partnership support EMCBP
Should be Empty:

EMCBP - MEMBERSHIP APPLICATION FORM

Trustees:

Thank you for your interest in The East Manchester Community Boat Project.

References:-

Insert Name plus Email address and/or Postal Address

Reference 1:

Reference 2:

In signing this application, I hereby agree to:

Elcometer Limited and Topping Partnership support EMCBP

Thank you for your interest in
The East Manchester Community Boat Project.