About you
Your first name (s)
Required
Your family name
Required
Your address
Your contact number (This is the number we will use to contact you.)
Required
Your email address
Required
Volunteer role
Your availability: How many hours are you able to give to this role? (number of hours per week, times of the week, e.g. morning, afternoon, evening, or weekend and for what duration, e.g. minimum 6 months)
Required
Tell us about any volunteering experience or any previous employment you have that is relevant?
Required
Are there any particular skills you would like to develop by volunteering with DCHS?
Required
Pre-volunteering Health Declaration
In order to ensure compliance with pre-placement checks required within the NHS, with current disability legislation and to ensure that DCHS provides you with any support during your work experience we need you to respond to the following statement.
**Conditions which may be relevant include back injury, skin disease, epilepsy, diabetes or psychological illness.
If 'yes', we will discuss your particular situation and any reasonable adjustments at the next stage of the application process.
References
Who should you ask to be your referee? We suggest this is your previous employer/volunteer supervisor, a religious or cultural leader, teacher or tutor, case worker, social worker or community leader.
Referee 1
Title
Required
Full name (first name and family name)
Required
Address
Contact number
Required
Email address
Required
Job title
Required
What is your relationship with the referee?
Required
Referee 2
Title
Required
Full name (First name and family name)
Required
Address
Contact number
Required
Email address
Required
Job title
Required
Rehabilitation of Offenders Act 1974
The Rehabilitation of Offenders Act 1974 (as amended) helps rehabilitated ex-offenders back into work by allowing them not to declare criminal convictions after the rehabilitation period set by the Court has elapsed and the convictions become 'spent'. During the rehabilitation period, convictions are referred to as 'unspent' convictions and must be declared to employers.
If yes, please supply details below.
Agreement/signature of volunteer applicant
