HOME START

Home-Start Sutton Home-Start is committed to safe recruitment practice as an important part of safeguarding and protecting children and vulnerable adults.

Confidential: If you have difficulty completing this form, please do not hesitate to ask for assistance.

Home-Start Sutton a company limited by guarantee, Registered in England and Wales no. 05165417, Registered Charity no. 1104960

Alexandra Gardens Children's Resource Centre, Stanley Road, Carshalton, SM5 4LJ Tel: 0208 6476501 Email: admin@homestartsutton.org.uk Web: www.homestartsutton.org.uk

REFERENCES: Please give the name & address of 2 referees that you have known for a minimum of 2 years (not a relative), include at least 1 professional reference, (previous employer wherever possible; alternatively, school, college or other professional such as a religious leader or a volunteer supervisor) who may be contacted by Home-Start. Please ask permission prior to giving referee details and confirm full address with them

Time known this person: In what capacity:

The minimum time commitment we ask of volunteers is 2- 3hours per week on a regular basis for at least one year with occasional additional time for training and support/supervision is this manageable?Yes/No

How did you hear about Home- Start? 

As volunteers are in a privileged position visiting families in their own homes and have contact with young children, Home-Start has a responsibility to ensure that no one becomes a volunteer who would misuse this trust. Therefore, it is essential that you complete and sign this form.

Have you had any personal contact with Social Services/Social Work Department or NSPCC in connection with children in your care? Have any of your children been subject to a child protection, child in need plan or assessment? Do you consider yourself to have a disability or health condition and if so what adjustments couldYes/No Home-Start provide to enable you to volunteer? Please provide detail, continue on separate sheet if required.

Have you ever been dismissed from any paid or voluntary work?

Have you ever been arrested or had contact (e.g. received a warning/caution/ attended court) with the police for any type of criminal offence? Are there any matters outstanding which may lead to a criminal prosecution?

If you do not declare existing or spent cautions or convictions you may not be selected. However, if you declare any of the above it may still be possible to become a volunteer

I know of no reason why I would be unsuitable to be a Home-Start volunteer. I will report any changes in my circumstances which may affect my role*

I give permission for Home-Start Sutton, to carry out checks e.gDBS/PVG/Access N) at enhanced level or other checks with the appropriate agency. I understand that failing to declare my involvement no matter how minor, with the Police/ Criminal Justice system may result in my being deemed unsuitable as a volunteer. I understand that my national insurance number will be required and that personal information about me will be held in records (including electronic records) some of which may be sensitive information such as age, race, gender, disability and that this information may be used for monitoring purposes.

I agree to the scheme holding this information and understand that I may ask to see my records at any time.