Volunteer Application Form

Volunteer Application Form

Please complete the application form below. Provide accurate details and complete all relevant sections.
Personal Details
Full Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Postcode
Email Address
example@example.com
Emergency Contact Details
Name of Emergency Contact

First NameMiddle NameLast Name
Relationship to You
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternative Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Volunteering Availability & Interests
Shop
The Mayfield Older People's Centre
Cafe
General
When are you available to volunteer? Please tick all times you are available.
Skills & Experience
Previous Employment / Volunteer Experience
Skills & Qualifications

Other
Why do you want to volunteer with us?
How did you hear about us?
Health and Support Needs

Do you have any medical conditions, health issues, or disabilities that we should be aware of to ensure we can support you safely in your role?
Criminal Convictions (If applicable)

Under the Rehabilitation of Offenders Act 1974, do you have any unspent criminal convictions? Please note, roles undertaken in our Day Centre require a DBS check
Please give details of any unspent criminal convictions
References
Referee 1 Name

First NameMiddle NameLast Name
Referee 1 Relationship to You
Referee 1 Email
example@example.com
Referee 1 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Referee 2 Name

First NameMiddle NameLast Name
Referee 2 Relationship to You
Declaration & Data Protection
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Volunteer Application Form

Personal Details

Emergency Contact Details

Volunteering Availability & Interests

Skills & Experience

Health and Support Needs

Criminal Convictions (If applicable)

References

Declaration & Data Protection