Volunteer Application Form

Volunteers’ Personal Details
Name
Address
Postcode
Telephone	Daytime		Evening
Any previous addresses in last two years
Date of birth		Place of birth
Children’s names		Age	Please give information about your parenting experience.
1
2
3
4
Transport to be used		Car	Bus	Other
Current clean driving licence held			Yes	No
E-Mail Address:
Ethnic Monitoring
Nationality
Religion
Languages spoken
Ethnic Origin Ethnic Origin (continued)	Asian	Black	White	Other
	Asian British	Black British	White English	Irish Traveller
	Bangladeshi	Black African	White Irish	Gypsy
	Indian	Black Caribbean	White Scottish	Any Other Background
	Pakistani	Any Other	White Welsh
	Any Other Asian		Any Other White – a) Polish b) Portuguese c) Any Other

	Chinese	Mixed
	Chinese	White & Asian
	Chinese British	White & Black African
		White & Black Caribbean
		Any Other Mixed
Where did you hear about Family Friends?

Please give details of any voluntary/paid work you have done, particularly with children and families:

Please give brief details of any other work you have undertaken:

Please give details of your current work/training commitments:

What is the minimum time you could offer to Family Friends as a volunteer on a regular weekly basis?

What are your hobbies and leisure interests?

Describe any personal skills or experiences you have which you feel may be relevant to a Family Friends Volunteer’s role:

Availability to attend Preparation Course:

Daytime 5

Evening 5

Which Day best ………………………………..

Why do you want to be a Family Friends Volunteer?

Is there any other information you would like to add?

Please give the names and addresses of two referees (not a relative) who may be contacted by Family Friends.

Name

Address

Postcode

Phone Number

Name

Address

Postcode

Phone Number

CONFIDENTIAL

As volunteers are in a privileged position visiting families in their own homes and have contact with young children, Family Friends has a responsibility to ensure that no one becomes a volunteer who would misuse this trust. Therefore, it is essential that you complete and sign this form.

Name:
Have you had any personal contact with Social Services/Social Work Department or NSPCC/Children 1^stin connection with children in your care?	Yes/No
Do you have any medical condition (physical or mental) that could affect your work as a volunteer?	Yes/No
Have you ever been dismissed from any paid or voluntary work?	Yes/No
Have you ever been arrested or dealt with by the police for any type of criminal offence?	Yes/No
Are there any matters outstanding which may lead to a criminal prosecution?	Yes/No
If you answer yes to any question, please give details: If you do not declare existing or spent cautions or convictions you may not be selected. However, if you declare any of the above it may still be possible to become a volunteer.

I give permission for Family Friends to carry out criminal record checks at enhanced level with the appropriate agency and an Independent Safeguarding Authority check. I understand that my National Insurance number may be required for identification purposes.

I know of no reason why I would be unsuitable to be a Family Friends volunteer.

I understand that Family Friends may hold personal information about me in records and on their computer, including sensitive information such as age, race, sex and disabilities that they will use for their monitoring purposes. I agree to them holding this information and understand that it may be shared with Family Friends for Quality Assurance purposes.

I understand that I may ask to see my records at any time.

Signed: Date:

Address

Postcode

Daytime

E-Mail Address:

Ethnic Monitoring

Asian

Black

White

Other

What are your hobbies and leisure interests?

Why do you want to be a Family Friends Volunteer?

Is there any other information you would like to add?

Please give the names and addresses of two referees (not a relative) who may be contacted by Family Friends.