Volunteer Application Form

Your Personal Details:

Title -- Select an option -- Miss Mrs Ms Mr Dr Other

If other, please specify *

First Name *

Surname *

Preferred Pronouns (optional) *

Date of Birth *

Address line 1 *

Address line 2 *

Address line 3 *

Postcode *

Your Contact Details

Home phone number *

Mobile phone number *

Preferred Phone Number

Home phone number Mobile phone number

Email address *

Emergency Contact Details:

Name *

Relationship to you *

Phone number *

Volunteer Opportunities:

Please tick the services you wish to be considered for:

Befriending Community Engagement Digital Inclusion Programme (DIP) Advice Reception Day Centre

If you have a preferred option from the list above, please tell us below. We will do our best to accommodate this, but it may not always be possible. *

About Yourself:

Why are you interested in volunteering for us? *

Have you done any voluntary work before? *

What could you bring to Age UK Wandsworth? *

Your Availability:

Please let us know the day(s) and time(s) you may be available to volunteer below (include weekends and evenings if relevant): *

Please let us know of any other times when you would not be available (e.g. school holidays, exam periods, or other fixed commitments): *

Where did you hear about volunteering with us?

Tick all that apply

Word of mouth Age UK national website Age UK Wandsworth website Age UK Wandsworth staff/volunteer Social media post Poster campaign Local library Other

If other, please specify *

References:

Reference 1: *

Preferred Phone Number *

Email address *

Address: *

How are they known to you? *

Reference 2: *

Preferred Phone Number *

Email address *

Address: *

How are they known to you? *

Criminal Offences and DBS Check:

Do you give your permission for Age UK Wandsworth to carry out this check?

Yes No

Have you ever been convicted of a crime, cautioned, warned or reprimanded in the UK or in any other country, including all unspent convictions? (If you answer yes to this, we may contact you to discuss before submitting your DBS application)

Yes No

Your Entitlement to Work or Volunteer

Communications & Consent

Do you consent to Age UK Wandsworth contacting you regarding your volunteering post?

Yes No

Preferred method of communication

By phone By email By post

Do you consent to Age UK Wandsworth sending you other information about Age UK Wandsworth?

By email By post

Equal Opportunities:

Do you identify as:

Male Female Self Identify Prefer not to say

If you ticked 'Self Identify' please enter details here: *

Age:

18-25 26-40 41-55 55-64 65 and over Prefer not to say

Are you:

Employed Unemployed Retired Student Other Prefer not to say

If you ticked 'Other' please enter details here: *

Do you identify as a member of the LGBTQ+ community?

Yes No Prefer not to say Prefer to self-describe

If you ticked 'self-describe' please enter details here: *

Do you have a religious affiliation?

Yes No Prefer not to say Prefer to self-describe

If you ticked 'yes' or 'self-describe' please enter more details here: *

Do you have a disability?

Yes No Prefer not to say

If you answered 'yes' please share any details of how we can support you: *

Ethnic Background:

White British White Irish White Gypsy or Irish Traveller White Roma Black British Black African Black Caribbean Asian British Asian Bangladeshi Asian Chinese Asian Indian Asian Pakistani Mixed White and Asian Mixed White and Black African Mixed White and Black Caribbean Arab Any other ethnic background (please specify below) Prefer not to say

Any other ethnic background (please enter details below): *

Declaration:

I give my consent for Age UK Wandsworth to store and process my information as per the declaration above, and declare that to the best of my knowledge the information provided on this form is correct. I will inform Age UK Wandsworth as soon as possible if anything changes.

I agree I disagree

Submit