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Register To Volunteer
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Indicates required field
Name
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First
Last
Address Line 1
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Address Line 2
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Town/City
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County
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Postcode
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Daytime Telehone
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Evening/Weekend Telephone
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Email
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Your Role
Availability
Please give details of the days/times you may be available to volunteer. Please give all possibilities and we will contact you to confirm your availability, where necessary.
Monday
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Morning
Afternoon
Evening
Tuesday
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Morning
Afternoon
Evening
Wednesday
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Morning
Afternoon
Evening
Thursday
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Morning
Afternoon
Evening
Friday
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Morning
Afternoon
Evening
Saturday
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Morning
Afternoon
Evening
Sunday
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Morning
Afternoon
Evening
Notes
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Skills/Knowledge
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Please let us know if you have any specific skills, knowledge or qualifications that you could offer to benefit the charity.
Please let us know if you have any specific skills, knowledge or qualifications that you could offer to benefit the charity.
If you feel that your skills are not relevant to the charity, please don't let this put you off volunteering, we are always looking for enthusiastic volunteers who are willing to learn too!
In what area would you like to volunteer your time? (tick all that apply)
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Admin (office)
Attending events
Family counselling
Family support work
Street fundraising
Telephones (office)
Other
If other, please give details
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Disability Discrimination Act 1995
The Disability Discrimination Act 1995 defines a person with a disability as 'A physical or mental impairment which has a substantial adverse long-term effect on his or her ability to carry out normal day to day activities'.
Do you have a disability which might affect your ability to volunteer for us, or which may require special arrangements?
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Yes
No
If yes, what facilities, adjustments or equipment might enable you to perform a role?
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Medical Details
Do you suffer from any medical conditions that we should know about?
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Yes
No
i.e. epilepsy, blackouts, migraines, fits, reduced or blurred vision, raised blood pressure, pneumonia, emphysema, jaundice, hepatitis, gout, anxiety, depression, cancer, hearing problems, vertigo, multiple sclerosis, angina, heart disease, colour blindness, blood disorders, asthma, arthritis, diabetes, skin disorders
Details:
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Do you have any allergies we should be aware of?
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Yes
No
Details:
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Have you had any operations or surgical procedures that we should be aware of?
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Yes
No
Details:
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Are you currently receiving or awaiting treatmend for any condition/illness that we should be aware of?
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Yes
No
Details:
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Doctor's Name
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Doctor's Surgery Address
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Doctor's Telephone
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Next of Kin Name
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First
Last
Next of Kin Mobile
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Next of Kin Email
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Declaration
By submitting this form, I declare that the information given in this questionnaire is true and complete. I will notify you immediately if any of my answers change. I understand that the information provided on this form will be stored either on paper records or a computer system, in accordance with the Data Protection Act 1998 and the new GDPA rules, and will be processed solely in connection with the volunteer process.
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