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
References
Reference one
Reference One Name
Reference One Address
Reference One Telephone
Reference One Email
Reference One Ok to send by email?
Reference two
Reference Two Name
Reference Two Address
Reference Two Telephone
Reference Two Email
Reference Two Ok to send by email?
Data protection
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.
Confirmation
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.
