Volunteer Form – Brazelton Centre UK

Full Name*

Prefered Title

Date of birth (optional)

Street Address

Address Line 2

City*

County / State / Region*

Postal Code / ZIP*

Country

Email Address*

Your skills and interests (please tick)

Projects which may interest you (please tick)

Admin / Clerical
Event Planning
Fundraising / Bid Writing
Research
Exhibitions
Media / Marketing

Experience as a Volunteer*

Work Experience*

Hobbies and Interests*

Why would you like to be a volunteer with The Brazelton Centre UK?*

Do you have any Criminal Convictions (other than minor driving offences)?*

Yes
No

If yes, please state the date and nature of conviction

Approximately how much time would you like to give each week?

Please indicate particular days or times

Please give two independent referees who would be willing to supply a character reference (these must not be family members)

Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Number

Email

After our initial meeting we will contact your referees. Please note we need two satisfactory references before you can start as a volunteer and we cannot always guarantee a suitable role.

Any information given on this form is confidential and covered by the Data Protection Act 1998

Confidential

Recruitment of Ex-Offenders - Some of the Brazelton Centre UK’s volunteering opportunities will involve direct contact with potentially vulnerable people and children. As such, applications to volunteer are exempt from the Rehabilitation of Offenders Act 1974.

This means that potential volunteers are required to declare their entire criminal record, including cautions, reprimands, final warnings and criminal convictions categorised `spend’ under the above legislation.

Please complete and sign this section. The information provided will be kept confidential.

It will only be disclosed to specific staff if/when they are considering you for specific volunteering opportunities (where you may come into contact with potentially vulnerable adults/children).

Have you ever been convicted at a Court or Cautioned by the Police for any offence?*

Yes
No

If yes, please give details, including date(s) and nature of offence(s):

I declare the above information in the application is correct. I give consent to The Brazelton Centre UK to hold my data solely for the purposes of progressing my application.

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Name

This field is for validation purposes and should be left unchanged.