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1 VOLUNTEER APPLICATION FORM

Please return to: Sally-Ann Burley, National Coal Mining Museum for England, New Road, Overton, Wakefield, West Yorkshire, WF4 4RH or email to Sallyann.burley@ncm.org.uk Please continue on additional sheets if required.

YOUR DETAILS Title:

_____________________________________

Surname:

_____________________________________

First Name/s:

_____________________________________

Home address Inc post code

_____________________________________ _____________________________________ _____________________________________

Home Telephone

_____________________________________

Mobile telephone

_____________________________________

Email address

_____________________________________

VOLUNTEER OPPORTUNITY Role Applied For:

_____________________________________

How did you find out about this role?

_____________________________________ _____________________________________

Have you any previous _____________________________________ volunteering experience, or are you currently _____________________________________ working as a volunteer? _____________________________________ _____________________________________

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2

EMPLOYMENT DETAILS Are you at present: Full-time student

Part-time student

Employed

Unemployed

Retired

Current or most recent employment: Dates:

_____________________________________

Company Name and Address

_____________________________________ _____________________________________ _____________________________________

Job Title:

_____________________________________

Description of duties:

_____________________________________ _____________________________________ _____________________________________

EDUCATION Current or most recent education Date:

_____________________________________

Establishment:

_____________________________________

Study undertaken:

_____________________________________ _____________________________________

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3

RELEVANT SKILLS Please give details of any skills you feel may be relevant to your application (previous work or volunteer experience, training etc)

_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________

Do you have any mining history knowledge

_____________________________________ _____________________________________ _____________________________________

Have you experience of using a computer?

_____________________________________ _____________________________________ _____________________________________

INTERESTS What are your main leisure interests?

_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________

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4 REFEREES We require two referees for all applicants for volunteer opportunities. Please give the names and addresses of two referees (not related to you). 1. Name:

_____________________________________

Address:

_____________________________________ _____________________________________

Telephone Number:

_____________________________________

In what capacity do they know you?

_____________________________________ _____________________________________

May we approach this referee now?

Yes

No

2. Name:

_____________________________________

Address:

_____________________________________ _____________________________________

Telephone Number:

_____________________________________

In what capacity do they know you?

_____________________________________ _____________________________________

May we approach this referee now?

Yes

No

DECLARATION I declare that the information I have given is true to the best of my knowledge. Signed:

_____________________________________

Date:

_____________________________________

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volunteer-application-form