Application form

Please provide details of two Referees (they must not be relatives or reside at the same address as you)

Referee 1

Referee 2

Emergency Contact

Conflict of Interest 

For this application to volunteer with Age UK East London we need to ask about potential conflicts of interest.

Please note that should any such conflicts of interests arise or become known and not declared, may result in the volunteering role being suspended or terminated.

Examples of possible conflicts of interest are as follows - by volunteering in the role, you could:

• Further your own financial interests
• Benefit a third party with whom they are associated
• Discriminate against a service user due to their political or religious views or allegiances

• Refer people to agencies with whom you have a connection
• Unfairly benefit a service user to whom they are related
• Be involved with groups whose values are in conflict with those of the Charity

Please can you confirm below that you whether you have any potential conflicts of interest that may be in conflict with volunteering.

There are some Age UK East London projects that need to submit monitoring information to the Lead Partner Organisation/ funder(s). On these occasions we will forward your details to the organisation who will store this information on a secure internal recording mechanism.

Samples of Age UK East London’s case files are checked by external auditors to check the quality of our service.  They have a professional duty to keep all information confidential.  We will only let them see files where we have consent to do so.

Your details