Volunteer Registration Form s2

Level 2 Alabaré DBS REQUIRED Volunteer Registration Form When volunteering for Alabaré you may be involved in many different aspects of the work including, Homes and Services for Veterans, Learning Disabilities, Young People, Generic Homelessness, Shops, Chaplaincy and Central Services.

Where did you hear about this Role? Personal details Title: Mr □ Mrs □ Miss □ Ms □ Other (please specify) First name(s): Surname: Email: Contact Address:

Postcode: Tel Day: Eve: Mobile: Volunteering If you know what role or type of volunteering you would like to do, please give details of this. If you are not sure look at the options below.

Office/computer skills Administrator Desktop pub/Graphic design Fundraiser Internet/Social media MS Office skills Project Manager Receptionist Web skills Working with individual & groups of people Befriender / Mentor/Life Sleep overs skills Working with Elderly Working with Learning disabilities General interests/Leisure/other skills/vocations Other Languages Spoken Arts & Crafts Café worker Cook General interests/Leisure/other skills/vocations cont… DIY skills Driver with own vehicle Finance/Budgeting Gardener experience

Keep fit Leisure passion…………………………….. Organising activities Shop assistant

Window cleaner Other ……………………………………………

Alabaré Christian Care Centres is a company limited by guarantee, trading as Alabaré Christian Care & Support. Registered in England No. 2604011. Registered Charity No. 1006504. Registered Office Riverside House, 2 Watt Road, Salisbury SP2 7UD T: 01722 322882 F: 01722 323325 volunteering @alabare.co.uk www.alabare.co.uk Are you currently using Alabaré Services Yes / No Availability How regularly do you wish to volunteer? Monthly □ Fortnightly □ Weekly □ More often □ When would you be AM* PM* Evening available to volunteer? Mon Tues Please tick the hours you are available to volunteer, but Wed note that not all roles are Thurs available at all times. Fri Sat Sun

* AM will normally be until 1pm and PM from 1pm Additional information Do you have a current driving licence?: Yes □ No □ If yes, do you have the use of a car?: Yes □ No □ Other Languages Spoken

Do you have the right to volunteer in the UK?: Yes □ No □ If you are here on a visa, there may be restrictions.

About you What interests, skills and experience could you bring to Alabaré? Please give examples from your home or work life and include why you would like to volunteer for us.

Special requirements We welcome applications from volunteers with disabilities. Do you have any special requirements/health issues that you would like to tell us about or that may have an impact on the activity that you can do?

Status

□ In education □ Looking after home or family

□ F/T employment □ Out of work due to sickness/disability

□ P/T employment □ Carer Page | 2 □ Retired □ Other (please specify)

□ Unemployed References Please give details of two referees. Both should know you well and for a minimum period of twelve months. Referees should not be family members. We will only contact them if you are accepted as a volunteer. Please supply, if at all possible Email addresses and/or Mobile numbers for your referees. Thank you Referee one Referee two Name: Name:

Address: Address:

Telephone: Telephone:

Email: Email:

How do you know this How do you know this person? person? How long have you known them? How long have you known them?

Date of birth Are you under 18? If yes, please give you date of birth.

Medical information Please let us know if:- - You currently receive medical treatment or medication? - Have consulted a medical professional in the last year for any health problems? - Are having any/awaiting any investigations of any kind at the moment?

Answers

Next of kin Contact in case of emergency (if different from Next of kin) Name: Name:

Address: Address:

Telephone (home): Telephone (home):

Telephone (work): Telephone (work): Page | 3 Mobile: Mobile:

Email: Email:

Relationship to you: Relationship to you:

Data protection act Your personal details will be treated as confidential and kept for no longer than necessary. If you are accepted as a volunteer, the information you have provided on this volunteer registration and monitoring information form will become part of your volunteer records which will be used to plan and record your practical involvement as a volunteer.

We would like to keep you informed about Alabaré News, fundraising events and volunteering activities other than the one you have applied for. If you do not want to be contacted about these opportunities, please tick if you are not happy to be contacted by:

Phone □ Post □ SMS text □ Email □ Declaration

I am aware that the information I have provided will be treated confidentially and consent to it being used and stored in the capacity stated:

I understand that in undertaking Volunteer work with Alabaré Christian Care and Support I may have access to confidential information. I agree to comply with the charity’s policies and further understand that I will not disclose confidential information to any outside individual or agency without permission from an authorised person.

I confirm that the information I have given on this form is correct and complete and that misleading statements may be sufficient grounds for cancelling any agreements made.

Signature:

This form is to be completed by over 18’s only. You will need parental consent if you are under 18.

Parent / Guardian Name …………………………………………………. Signature……………………………………………….

Please return completed form to:

Office use only Date received: Volunteer Code: Notes:

Page | 4 Volunteer monitoring information We welcome interest from anyone wishing to volunteer for Alabaré. We aim to reflect the diversity of the local community in terms of ethnic and cultural background, gender, age and disability. Therefore, we ask all potential volunteers to complete the details below. The information will be used for compiling statistics for monitoring purposes and will be treated confidentially.

Please note that the completion of any part of this form is entirely voluntary.

Ethnic group Black or Black Asian or Asian White Mixed Chinese or Other British British

□ □ Indian □ British □ White and □ Chinese Caribbean Black □ Pakistani □ Irish Caribbean □ Any □ African other □ □ Other □ White □ Other Bangladeshi White and Black background Black African background □ Other Asian □ White background and Asian

□ Other Mixed background Where ‘other’ is ticked, please provide further information:

Gender

□ Male □ Female Age

□ 15 or under □ 16-17 □ 18-24 □ 25-34

□ 35-44 □ 45-64 □ 65+

Sexual orientation

□ Heterosexual □ Homosexual □ Bisexual Religion

Disability Under the Equality Act 2010, a person is defined as disabled if they have a physical or mental impairment which has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. Page | 5 Would you consider yourself to be disabled as defined under the Equality Act 2010?

□ Yes □ No If you have answered yes to the above question, please indicate which category best describes your disability:

□ Hearing □ Mental health

□ Sight □ Physical/motor disability

□ Speech impairment □ Language disability

□ Learning difficulties □ Other (please specify):

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