Online Support Group Leader
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Volunteer Application Form Online Support Group Leader
[To fill in this form electronically, please press tab to move through the document.]
Your details
Name:
Address:
Postcode:
Preferred contact number:
Email:
Occupation:
Membership no: (
Motivation
What interests you about volunteering for Endometriosis UK:
Availability
Please give details about how many hours you would be available for per week :
Are you prepared to attend annual training? (All expenses are paid for by the charity)
Registered Charity No. 1035810. Company Limited by Guarantee No: 2912853 YES NO
Knowledge
Do you have any prior knowledge of endometriosis? Please give details
Relevant skills
What qualities and skills that you have gained from your personal, work or voluntary experience do you think you can bring to a volunteer role at Endometriosis UK:
Are you confident with the use of technology such as Skype? YES NO
Do you have access to a computer in a comfortable, quiet setting? YES NO
Please tell us anything else about yourself that you feel is relevant:
Registered Charity No. 1035810. Company Limited by Guarantee No: 2912853 About you
It would be helpful if you could give us some information about you as a person – your interests, work, study etc.
Registered Charity No. 1035810. Company Limited by Guarantee No: 2912853 Referees Please give us the names and addresses of two people who can confirm your suitability for this role. One of your referees should have known you for at least three years. Your referees cannot be family members.
REFEREE 1
Name:
Address:
Postcode:
Daytime telephone:
Email:
Please tell us how you know this person:
REFEREE 2
Name:
Address:
Postcode:
Daytime telephone:
Email:
Please tell us how you know this person:
Registered Charity No. 1035810. Company Limited by Guarantee No: 2912853 Signature (if filling out in hard copy) Date: (dd/mm/yy): // When completed, please return this form to:
THE SUPPORT NETWORK MANAGER Endometriosis UK Suites 1&2 46 Manchester Street London W1U 7LS or save the form and email it to: [email protected] or fax the form to: 020 7935 5748
For further information: t: 020 7222 2781 www.endometriosis-uk.org
Registered Charity No. 1035810. Company Limited by Guarantee No: 2912853 Registered Charity No. 1035810. Company Limited by Guarantee No: 2912853