How to Apply

Personal Details

Title

Forname

Surname

Address

Postcode

Contact Information

Home

Mobile

Email Address

Email is our preferred method of communication as it is speedy and cost effective

Background Information

What prompted you to apply to become a Volunteer at St Mary's Hospice?
Newspaper ArticleAdvertFacebookFriend or RelativePosterTwitterRecruitment/PresentationOther
If other please specify

Volunteering/Skills/Experience

Please tell us about any voluntary work you have done

Please list any skills, interests/hobbies or work experience you have

Volunteering Opportunities

Volunteering Opportunities
GardeningLiving Well Programmes & ActivitiesReceptionDay HospiceRetail Shops & Furniture WarehouseIn Patient Unit – serving meals/befriendingRetail DriverPatient transporting driversMaintenance - Vehicle & BuildingsComplementary TherapiesFundraising & EventsFamily Support & BereavementThe Orangery CafeAdministrationOnline Retail

Availability

Please select the times you are available.

Those wishing to volunteer more flexibly i.e. not commit to a regular time e.g. Fundraising Events, Bank Cafe, Bank Reception
Please indicate any times you are not available (e.g. school holidays)

Health Declaration

For Health and Safety reasons, it is important that we do not assign you the wrong task. A disability or health problem does not necessarily exclude you from volunteering for us but to enable us to assess you suitability for particular tasks we require information about your health.

Please describe any special needs, disability, allergies or other physical or mental health matters that may affect your ability to work as a volunteer that we should be aware of.

Have you experienced the death of a close relative or friend in the last 12 months?
YesNo
Was this someone who was a patient with St Mary’s Hospice?
YesNo

Were you involved with supporting this person?
YesNo

Driving

Do you hold a full UK driving licence?
YesNo
Do you have your own transport?
YesNo

Criminal Convictions & Disclosure and Barring

The nature of this type of voluntary work it is exempt from the Rehabilitation of Offenders Act 1975 (Exemption) Order 1975. This means that applicants are NOT entitled to withhold information of convictions, which for other purposes are spent. Previous convictions will not necessarily prevent you from becoming a volunteer.

Have you ever been convicted of a criminal offence?

This information will remain confidential and will be discussed at the interview stage.

Volunteers undertaking roles which may involve contact with vulnerable people will be required to have a DBS (police) check carried out.

General Data Protection Regulation 2018

The information you have provided is used to process your application to become a volunteer with St Mary’s Hospice only. The information is used by the Volunteer department and the area for which you volunteer, we do not share your information unless required to by law. Your personal information is stored securely electronically on our volunteer database or on paper records locked away.

Your data will be kept for 1 year after you stop volunteering.

If you do not progress with this application your data will be confidentially disposed of after 3 months.

Declaration

I declare the information given on this form is correct to the best of my knowledge. I give my consent for personal information to be recorded, used and stored solely by St Mary’s Hospice and a DBS to be completed if required.

Any applicant under 16 years of age must have permission off their parent or carer

References

Please give the names and addresses CLEARLY of two people who can tell us about you. For example, someone who knows you well, someone you have worked with, a teacher, someone from your community (this must not be a family member).

Reference One

Name
Address
Postcode
Phone Number
Email Address
Relationship to you

Reference Two

Name
Address
Postcode
Phone Number
Email Address
Relationship to you

Your Name

Your Email

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