DofE Volunteer Application Form
Please complete the form below
Name
First Name
Last Name
Date of Birth
-
Day
-
Month
Year
Date
E-mail
example@example.com
Address
Street Address
Street Address Line 2
City
County
Postcode
Tel: Number
*
Format: 00000000000.
Mobile: Number
*
Format: 00000000000.
Which project would you like to volunteer at?
Allotment
Cafe
Forest School
Fundraising Events
What days are you available to volunteer?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What school do you attend
School DOE contact (name and email address)
Do you have a EHCP (education, health & care plan) ?
*
Yes
No
If Yes - please give us a brief overview.
Emergency Contact 1. (Please give 2 emergency contacts if possible)
First Name
Last Name
Emergency Contact Tel No.
*
Format: 00000000000.
Emergency Contact 2.
First Name
Last Name
Emergency Contact Tel No.
Format: 00000000000.
Medication Do you have any medical conditions or take any medication?
*
Yes
No
Please detail any medical conditions or list any medication that you take or might need in case of emergency (inhalers etc.)
Allergies Do you have any allergies?
*
Yes
No
Please give details of any allergies.
Do you have epilepsy? At Mudlarks we have 999 support only with the exception of First Aid
*
Yes
No
If yes, are there any signs before a seizure occurs?
Image Consent We sometimes take photographs, films which are used to promote Mudlarks.
*
Yes
No
I understand there will be an initial 3-month probationary period upon joining Mudlarks as a volunteer.
*
Yes
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