Volunteer application form 2015

Page 1

Application for Volunteering

Personal Information Role Applied for: _____________________________________________ Surname: ____________________ Forenames: ____________________ Title: _________ Address: ___________________________________________________ ___________________________________________________________ YMCA BARRY Court Road Barry Vale of Glamorgan CF63 4EE T 01446 724 000 E info@ymcabarry.org.uk

___________________________________________________________ Post Code: ___________________ Home: ___________________ Mobile:___________________________ Date of Birth: ___/___/_____ NI Number: ________________________

Education and Employment School/College/University

Years attended Subjects Studied/Qualifications

Please note any employment (paid or voluntary) you would continue with if you were to be successful with this position in the YMCA. (If none, please leave blank)

Registered Charity No. 251245

Please outline below how you feel you would benefit from volunteering at YMCA BARRY (Please continue on an alternative sheet if required)

Supporting information

Please list here the names and addresses or contact details of two persons from whom Barry YMCA may obtain a reference. If you are still in school or college then you must list this as one. You may list a friend or neighbour. They will be contacted within two to three days of receiving your application. 1.


For completion by under 16 volunteers only

To be completed by the parent/guardian of the volunteer, where the volunteer is 16 years or younger.

Volunteers name: _________________________________________ Volunteers address: _______________________________________

I ___________________________________ understand the volunteering tasks that my child will be involved in and give my permission for them to volunteer at the Barry YMCA.

Signed (Parent/Guardian): _______________________

Print Name: __________________________________ Relationship to volunteer: _______________________

Emergency contact number: _____________________ Date: ______________

Declaration Please list any criminal convictions except those deemed “spent� under the Rehabilitation of Offenders Act 1974. If none, then please state as such. In certain circumstances, volunteering with Barry YMCA is dependant upon obtaining a satisfactory basic disclosure from the Criminal Records Bureau/Scottish Criminal Records Office.

I confirm that the above information is complete and correct and that any untrue or misleading information will give Barry YMCA the right to terminate any volunteering opportunity offered. I agree that Barry YMCA reserves the right to require me to undergo a medical examination. (Should we require further information and wish to contact your doctor with a view to obtaining a medical report, the law requires us to inform you of our intention and obtain your permission prior to writing to your doctor). I agree that this information will be retained in my personnel file during volunteering and for up to six years thereafter and understand that information be processed in accordance with the Data Protection Act. I agree that should I be successful in this application, I will, if required, apply to the Criminal Records Bureau/Scottish Criminal Records Office for a basic disclosure. I understand that should I fail to do so, or should the disclosure not be to the satisfaction of Barry YMCA, then any offer of volunteering may be withdrawn or my volunteering opportunity terminated.




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