BCDG COVID-19 Volunteer Application Form

1

We are using this form to create a database of people that wish to volunteer to help vulnerable people in the community that are in need of assistance during this trying time.

2

Name* This field is required.

First Name

Last Name

3

Contact Phone Number* This field is required. Please provide your own mobile number

4

E-mail* This field is required.

example@example.com

Confirm Email

5

What activities can you like to volunteer for in the Ballycastle Area?* This field is required.Select whatever applies

Collecting and delivering groceries for vulnerable and isolated individuals

Collecting and delivering prescriptions to vulnerable and isolated individuals

Helping distribute emergency food boxes/ meals to vulnerable people

Dog Walking for a vulnerable/isolated person

A friendly phone call and check in with a vulnerable/isolated person

6

Do you have access to a vehicle, and are you planning to use the vehicle during your volunteer role? (opportunities for volunteers without vehicles are available also)* This field is required.If you're using your vehicle it's essential that you inform your insurance company that you will be using your vehicle for your volunteer role, and ensure your insurance cover is adequate and covers your activities. (We may request a copy of your insurance policy)

Yes

No

7

Have you informed your vehicle insurance company that you will be using your vehicle for your volunteer role?* This field is required. It's essential that you inform your insurance company that you will be using your vehicle for your volunteer role, and ensure your insurance cover is adequate and covers your activities. (We may request a copy of your insurance policy)

YESNO

8

Have you ever been “barred” by the Disclosure and Barring Service?* This field is required.

YESNO

9

Do you agree to an Access NI Check being carried out if required? * This field is required.If required an Access NI Check will be applied for.

YESNO

10

Have you read the BCDG Volunteer guidelines, and do you agree to follow these guidelines at all times while carrying out your volunteer role with us?* This field is required.

YESNO

11

Do you have any information you would like to add?