Volunteer Registration Form GRACE
Volunteer Registration Form GRACE
GRACE
Volunteer Registration Form
Title: Address:
First Name:
Surname: Town: Postcode:
Known As: Date of Birth: / / Gender: Male/Female
WHICH OF THESE BEST DESCRIBES YOUR ETHNIC GROUP? (TICK ONE ONLY)
White Scottish White Other British White Irish White Other
Asian Bangladeshi Asian Chinese Asian Indian Asian Pakistani
Asian Other Black African Black Caribbean Black Other
Mixed Background Not Supplied Other:_____________
WHICH OF THE FOLLOWING BEST DESCRIBES YOUR SITUATION? (TICK ONE ONLY)
Paid employment (full time) Incapacity benefit/E.S.A. School
Paid employment (part time) Income Support Further Education/Training
Self-employed Job Seekers Allowance Full time Parent
Retired/Early Retired Unwaged Carer
D.L.A. Asylum Seeker Other: _________________
If you are unemployed how long have you been so?
Do you have a Case Worker? (For example: Social Work, Job Centre Plus or NHS). Yes No
Yes No
Do you consider yourself to have a disability or any health issues that might affect
your volunteering?
Please give details:
SUPPORT INFORMATION (This will help us to find a more suitable placement for you).
WHICH OF THE FOLLOWING IS YOUR MAIN REASON FOR VOLUNTEERING ? (TICK ONE ONLY)
Meet new people Further Education/Training See a need & want to improve things
Use my spare time well Increase my confidence Help me into paid work/education
Help me learn new skills Improve my health Other:_________________________
If yes,
With use of my personal details
OR
Without use of my personal details
WHAT ROLE WOULD YOU LIKE TO DO? (TICK ALL THAT APPLY)
Administration/Office work
Advocacy/Human rights Justice/Legal assistance
Arts (music/drama/crafts) Information management
Befriending/Mentoring Management/Business skills
Campaign/Lobbying Marketing/PR/Media
Care/Support worker Practical/DIY
Catering/helping in kitchen Research/Policy work
Computing Sports, outdoor activities
Conservation/Gardening Tutoring/Supporting
learners
Counselling Fundraising
Driving/Escorting Assisting with course
registration
Finance/Accountancy Welcoming members/tea
coffee
WHAT SKILLS DO YOU HAVE THAT YOU CAN BRING TO VOLUNTEERING? (TICK ALL THAT APPLY)
Administration DIY Management
Arts and Crafts Drama Marketing
Bookkeeping Driving Mountain Rescue/Survival
Caring First Aid Music
Catering Fundraising Retail/Shop
Childcare Gardening Sign Language
Committee Work Graphic Design Teaching
Computing Keep Fit/Sports Website Design
Counselling Languages
How many hours would you like to give each time? ______hours
YOUR INFORMATION
PROTECTION OF VULNERABLE GROUPS (PVG) SCHEME/DISCLOSURE CHECKS
Some organisations need to run police checks on people who want to be volunteers because they work with
children and adults who are vulnerable and/or at risk. These organisations will require your assistance in deciding
whether you should be a member of the PVG Scheme, hold a basic Disclosure; or hold a standard Disclosure in
order that you can participate fully in your volunteering opportunity.
Do you understand and accept why this may need to happen? Yes No
DECLARATION
I confirm the information provided is, to the best of my knowledge, correct and I am willing to commit
______________ hours to GRACE on _____________ each week/month
Volunteer Signature: Date: / /
It is our policy to take your details off our mailing list after 15 months from your registration date.
We will contact you about this nearer the time.