Volunteer Application Form 2019/20

For this scheme, a volunteer is someone who freely gives their time and skills for the benefit of the elderly client group and other volunteers within the team. Please complete this form as it relates to your volunteering role for the good and safe coordination of the project and for health and safety risk assessment for all participants.

Name *

First

Last

Please provide your full name.

Email *

Please supply a valid email address so we can contact you.

Date of Birth *

Please enter as DD/MM/YYYY.

Home Phone Number

Please provide a home phone number.

Mobile Phone Number

Please provide a mobile phone number.

Address & Postcode *

Please supply your full address including postcode.

How did you hear about us?

How would you like to volunteer?

Befriending & Companionship
Telephone Companion
Community Network Volunteer
WGN Staff Support

Befriending & Companionship - a MINIMUM of 1 hour/week
Telephone Companion - short daily morning and evening "How are you?" calls to an elderly person/s, providing chat and companionship
Community Network Volunteer - a more fluid volunteer role. You will work in pairs to identify people, places, individuals and resources in your community that could support the ethos of an Age Friendly Neighbourhood
WGN Staff Support - assistance hosting coffee mornings, lunches and the RBL vets/families weekly breakfasts

Please choose all that apply.

Referee 1 Name *

First

Last

Please provide details of someone who can vouch for you personally and professionally.

Referee 1 Address *

Please provide an address for your first referee.

Referee 1 Postcode *

Please provide a postcode for your first referee.

Referee 1 Email *

Please provide a valid email address for your first referee.

Relationship to Referee 1 *

Tell us your relationship with your first referee?

Referee 2 Name *

First

Last

Please provide details of someone who can vouch for you personally and professionally.

Referee 2 Address *

Please provide an address for your second referee.

Referee 2 Postcode *

Please provide a postcode for your second referee.

Referee 2 Email *

Please provide a valid email address for your second referee.

Relationship to Referee 2 *

Tell us your relationship with your second referee?

Volunteer Experience

Please give details of any previous volunteer experience.

Recent Employment

Please give details of your most recent employment.

Website

Declaration

Wythenshawe Good Neighbours (WGN) work mainly with elderly, vulnerable adults and young people and as such has a duty of care to all participants. With that in mind, WGN will conduct DBS checks through a third party Due Diligence Checking (DDC) if appropriate to your chosen role. It is important at this stage that you declare any offences that may appear on your police check. All declarations will be treated in confidence and will not necessarily bar you from working with the project. Completion of an induction is not an offer of a volunteer role.

Data Protection Act

I understand and agree that as part of my involvement with Wythenshawe Good Neighbours (WGN), my details will be held in a confidential database, which is only used for communications within the group and funding and supporting agencies. By submitting this form I declare that the above information is correct and accurate to the best of my knowledge. I understand that if accepted by WGN to undertake specific volunteer roles, I will need to consent to a DBS check.