A DBS check will be provided by WSCC. Volunteer application form template - support worker - 12116 Completing this form You will need to provide details of an emergency contact and any unspent criminal convictions.If you have a driving licence, it will be useful to have it available for reference.Depending on the role you are applying for you may be asked to give details of one or two personal referees, your qualifications, work experience and reasons for applying.The questions marked with an asterisk (*) are mandatory and require an answer. You do not have to answer all of the other questions, but it would help us if you do. Your data privacyBefore completing this form please read our general Privacy Policy (opens in a new window). This explains why we ask for your data, what we do with it and how long we will keep it. It also explains how you can find out what data we hold about you and how you can ask us to delete it. Name of volunteering role * Please select the volunteer role you are applying for. Volunteer support worker - Adult Day Services (Laurels Day Centre, Rustington) Volunteer support worker - Adult Day Services (Rowans Day Opportunities Centre) This form will take around 15 minutes to complete.Please allow yourself enough time to complete it in one session as there is no option to save and come back to it later. Your details Title * Select your title. Mr Mrs Miss Ms Mx Dr Other Other Enter your title if not listed above. First name * Enter your first name. Last name * Enter your last name. House name or number * Enter your address name or number. This could be a flat, house or building name or number. Address line 1 * Enter the first line of your address. This could be the street name. Address line 2 Enter the second line of your address if you need to. This could be the village name. Town or city * Enter the town or city of your postal address. Postcode * Enter your postcode, with or without spaces. Email address Enter an email address where we can write to you. Phone number Enter a daytime phone number that we can ring you on. This can be a mobile or land line number. Unspent criminal convictions Select 'Yes' if you have been convicted of any criminal offence which is not considered 'spent' under the Rehabilitation of Offenders Act 1974.Criminal records will only be taken into account for recruitment purposes when the conviction is relevant. Having unspent convictions will not necessarily bar you from volunteering. Yes No Details of unspent criminal convictions Give details if you have selected 'Yes' above. Criminal convictionsOwing to the nature of its activities, this role is exempt from the provisions of the Rehabilitation of Offenders Act 1974 and its associated Order. This means you need to disclose details of any warnings, reprimands, cautions and convictions which would not be removed as part of the police filtering process when carrying out a Disclosure and Barring Service (DBS) check. See GOV.UK for guidance on this update service (opens in a new window). You will have the opportunity to discuss these details during your interview. You will also be subject to an enhanced Disclosure Barring Service check before you can proceed as a volunteer. Criminal records will only be taken into account when the conviction is relevant; having a conviction will not necessarily bar you from volunteering. Have you been convicted of any criminal offence or received any warnings, reprimands or cautions from the police which would not be removed under the filtering process of a DBS check? Select 'Yes' if the above statement applies to you. Yes No Details of criminal convictions or police warnings, reprimands or cautions Give details if you have selected 'Yes' above. Your qualifications Your qualifications Briefly list any qualifications you have, particularly those that are relevant to this role. Your work experience Paid or voluntary work experience, including dates Briefly outline all any paid or voluntary work experience, including the dates you started the role and if applicable, finished it. What has attracted you to this role? Having read the role description, briefly explain what has attracted you to apply for this volunteer role. Committing to this role Having read the role description, indicate if you are able to make a commitment to the time required to undertake this role. Driving licence information Driving licence * Select 'Yes' if you have a current driving licence. Yes No Driving licence has category D1 entitlement Select 'Yes' if your driving licence entitles you to drive category D1 vehicles. See GOV.UK for more information (opens in new window). Yes No Access to vehicles for use in voluntary role Select any of the below vehicles that you have access to use and would be prepared to use within the voluntary role if requested. Car Van Motorbike Scooter Bicycle Your references Please provide the name and contact details for two people (unrelated to you) whom you have known for three years in a personal, work or voluntary capacity who have agreed to provide a reference for you. First referee's first name Enter your referee's first name. First referee's last name Enter your referee's last name. First referee's house name or number Enter the address name or number. This could be a flat, house or building name or number. First referee's address line 1 Enter the first line of the address. This could be the street name. First referee's address line 2 Enter the second line of the address if you need to. This could be the village name. First referee's town or city Enter the town or city of the postal address. First referee's postcode Enter the postcode, with or without spaces. First referee's phone number Enter a daytime phone number that we can ring your referee on. This can be a mobile or land line number. First referee's email address Enter an email address where we can write to your referee. Second referee's first name Enter your second referee's first name. Second referee's last name Enter your second referee's last name. Second referee's house name or number Enter the address name or number. This could be a flat, house or building name or number. Second referee's address line 1 Enter the first line of the address. This could be the street name. Second referee's address line 2 Enter the second line of the address if you need to. This could be the village name. Second referee's town or city Enter the town or city of the postal address. Second referee's postcode Enter the postcode, with or without spaces. Second referee's phone number Enter a daytime phone number that we can ring your referee on. This can be a mobile or land line number. Second referee's email address Enter an email address where we can write to your referee. Your emergency contact Emergency contact's first name * Enter your emergency contact's first name. Emergency contact's last name * Enter your emergency contact's last name. Emergency contact's phone number * Enter a daytime phone number that we can ring your emergency contact on. This can be a mobile or land line number. Emergency contact's alternative phone number Enter another phone number we can reach your emergency contact on. This can be a mobile or land line number. DeclarationBy entering your name below and submitting this application form you are declaring that you have completed this application to the best of your ability and believe the information provided is accurate and correct. Your full name * Enter your full name to show you agree to the above statement. To send your form to us press the 'Submit' button once.After a few moments you will see our 'Thank you' page. If you do not see the 'Thank you' page we will not have received your form.
