Apply to volunteer Title (Required) Name (Required) Email (Required) Telephone (Required) Mobile Telephone Work Telephone Address 1 (Required) Address 2 Town/City (Required) Postcode (Required) Date of Birth
Emergency Contact Details
Emergency Contact Name Relationship to you Emergency Contact Telephone
About the Role
Role title & location one (Required) Role title & location two Role title & location three What would you like to gain from your volunteering experience? What are your interests and hobbies?
Which days would suit you best to carry out your voluntary work?
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Reference One Name Reference One Address Reference One Telephone Reference One Email Reference One Ok to send by email?
Reference Two Name Reference Two Address Reference Two Telephone Reference Two Email Reference Two Ok to send by email?
We will use your personal details in relation to your volunteering application and volunteering activity within Vivacity. Your details will be held on a computerised database. We never sell or pass your details to third parties.
May other Vivacity services contact you? No Yes
If yes, can we contact you by:
Contact - Post Contact - Phone Contact - Email
Criminal Record Bureau (CRB) disclosures
For some volunteering roles, it is our policy to obtain disclosures from the CRB. Any information given will be held in the strictest confidence and only used in consideration of your suitability for the volunteering role and will not necessarily prevent you from volunteering.
Have you been convicted of any criminal offence? No Yes If yes, please give details:
The exemptions to the Rehabilitation of Offenders Act 1974 require that the applicants must declare all spent or unspent convictions for roles that involve working with vulnerable clients.
I confirm that the information provided on this form is accurate to the best of my knowledge. I understand that any information submitted in connection with volunteering and subsequently found to be incorrect may result in the termination of my volunteering with Vivacity.