Volunteer Registration Form

Role applied for *

About You

Name *

Date of birth *

Address *

Post code *

Home phone number

Mobile number

Email *

Are you a Derby Homes resident? *

Yes

No

Do you hold a current full UK driving licence? *

Yes

No

Emergency Contact

Emergency contact name *

Emergency contact phone number *

Emergency contact email

Does your emergency contact give us consent to store their details? *

Yes

No

Skills & Interests

Education background, including training courses, life skills & experiences

Current / previous occupation

Hobbies, interests & skills

Previous volunteering experience

Availability

I am available *

Monday Morning

Monday Afternoon

Monday Evening

Tuesday Morning

Tuesday Afternoon

Tuesday Evening

Wednesday Morning

Wednesday Afternoon

Wednesday Evening

Thursday Morning

Thursday Afternoon

Thursday Evening

Friday Morning

Friday Afternoon

Friday Evening

Saturday Morning

Saturday Afternoon

Saturday Evening

Sunday Morning

Sunday Afternoon

Sunday Evenings

References

All we require two character references. Your references can be anyone who knows you, as long as they are not a family member.

Reference 1 name *

References 1 address *

Reference 1 phone

Reference 1 email

Reference 2 name *

Reference 2 address *

Reference 2 phone

Reference 2 email

DBS

Due to the nature of the work here at Derby Food 4 Thought Alliance, you could be working with vulnerable adults. As a result, we might have to apply for a Disclosure and Barring Service check (DBS). This will show any convictions you may have, past or present. This will not necessarily prevent you from volunteering here. Please let us know in the box below about any convictions you have.

Convictions (if any)

Do you have any additional support needs?

Data & Privacy

Community Action is the data controller for the purposes of processing personal data and complies with the General Data Protection Regulation 2018.

Community Action will hold personal data for the purpose of volunteering and will keep personal data only for as long as is necessary.

We will not provide information about you to other organisations, agencies or groups for marketing purposes. We disclose information about you only with your consent, or if we are required to do so by law.

Community Action will make every effort to ensure that your personal data is kept secure against loss, unauthorised access, disclosure; and destruction.