CROPS Volunteer Mentor Application Form
Mentoring young people is an amazingly rewarding role. Our mentors have found that having the opportunity to be part of helping young people through difficult times can be an incredibly rewarding experience
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
County
Post Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: 00000000000.
Mobile Number
Please enter a valid phone number.
Format: 00000000000.
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Is there any restriction on your eligibility to reside / work in the United Kingdom?
Yes
No
If the answer is YES, please specify such restrictions:
Which local church do you attend?
Why do you want to be a volunteer mentor?
How much time are you able to give and when?
Would you like to mentor in primary or secondary schools?
Please tell us about your experience in working with young people either in education, youth work, in the local church / Christian organisations, in the local community or any other experience that you feel is relevant.
Have you ever had an offer to work with children, young people or vulnerable adults declined?
Yes
No
If yes, please give details
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Disclosures. Information disclosed here will remain confidential.
Do you have any convictions, cautions, reprimands or final warnings that are not “protected” as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)?
Yes
No
If you stated yes, please give further details. Please include month and year and circumstance of the incident(s)):
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Please give details below of two people (not relatives) who know you well and would be able to give a reference, for example a colleague, a teacher or a minister. We would prefer one of these to be a church leader.
Reference 1 (Church leader)
First Name
Last Name
Address
Street Address
Street Address Line 2
City
County
Post code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: 00000000000.
Relationship
Reference 2
First Name
Last Name
Address
Street Address
Street Address Line 2
City
County
Post Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: 00000000000.
Relationship
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Next
Please note you will undergo DBS check (Enhanced level) through the Disclosure and Barring Service before starting mentoring.
Signed
Date
-
Day
-
Month
Year
Date
Submit
Should be Empty: