Volunteer Application Form

First name

Last name

Name you would prefer to be called or are known by: e.g. Ed for Edward, Tash for Natasha

Date of birth

Address

Postcode

Main telephone

Mobile

Email address

Volunteering

Role you are applying for:

Availability:

Please state which days, and if morning, afternoon, all day - specific hours, can be flexible

Interests and Experience

Why would you like to volunteer for Nottingham Hospitals Charity and what skills and experience can you bring to the role?

Medical Information

Do you have an illness or disability? YesNoPrefer not to say

Do you have any allergies? YesNoPrefer not to say

Are you taking any prescribed medication? YesNoPrefer not to say

If yes to any of the above please give details and tell us how we can support you in your role?

References.

Referees should be people who have known you for at least 2 years and are not family members.

Name of first referee

Relationship to you

Length of time you have known them

Address

Phone number

Email address

Name of second referee

Relationship to you

Length of time you have known them

Address

Phone number

Email address

Emergency Contact Details

First name

Last name

Relationship to Volunteer

Contact address

If different to applicant

Postcode

If different to applicant

Main telephone

Mobile

Email address

Data Protection Statement

Please tick this box if you consent to Nottingham Hospitals Charity recording and storing your personal information on our database.

I agree to having my data stored

This information will be held of a database to assist with monitoring and will be treated in the strictest confidence.

To find out more about what we do with your personal information and why, you can read our Privacy Policy here.

We would like to keep you up to date with our work by sending you our newsletter and information about fundraising activities, volunteering opportunities and events. You can opt out at any time by visiting our Contact Preferences page.

Please let us know if you are happy to hear from us.

OK to Email

YesNo

OK to Post

YesNo

Ok to Phone

YesNo

Please read the ICO guidance for more explanation of the requirements.

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Volunteer Registration Form

Volunteering

Interests and Experience

Medical Information

References.

Emergency Contact Details

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