Information Centre Volunteer Application Form

Fields marked with * are required and must be completed.

Personal details First name * Middle name Surname * Known as Address * Town/City * Postcode * Postcode Finder - opens in new window

Phone numbers

Home

Work

Mobile

Email address *

Person to contact in emergency Name * Relationship to you * Address * Town/City * Postcode * Postcode Finder - opens in new window

Phone numbers

Home phone

Work phone

Mobile phone

Availability

	Mon	Tue	Wed	Thu	Fri	Sat	Sun
10am-1pm	Monday 10am to 1pm	Tuesday 10am to 1pm	Wednesday 10am to 1pm	Thursday 10am to 1pm	Friday 10am to 1pm	Saturday 10am to 1pm	Sunday 10am to 1pm
1pm-4pm	Monday 1pm to 4pm	Tuesday 1pm to 4pm	Wednesday 1pm to 4pm	Thursday 1pm to 4pm	Friday 1pm to 4pm	Saturday 1pm to 4pm	Sunday 1pm to 4pm

Medical Information Medical information (Please provide details of any physical or mental condition which could affect your ability to work safely as a volunteer or which could affect the safety or wellbeing of other volunteers, employees, or visitors) Action required by others in an emergency

Skills and Experience Please outline relevant skills and experience Attach a CV (if possible) ( files must be of doc, docx or pdf type and no larger than 2MB)

Personal Statement What motivates you to offer your services as a volunteer? What do you hope to gain and to contribute?

Referees

Please provide 2 non-family, preferably workplace referees or similar who have known you for at least 2 years.

Referee 1 Name * Relationship to you

Phone numbers

Home

Work

Mobile

Referee 2 Name * Relationship to you

Phone numbers

Home

Work

Mobile

Declaration

I will agree to a Police vetting request *

All representation and information in this form or provided orally are true and complete. In applying for voluntary work I have disclosed all information about myself which is relevant to my ability to discharge the duties for which I am volunteering. I understand the police vetting results will be made known to me on my request. *

You will receive a thank you page in this browser window and a confirmation email upon successful submission of this online form.