Volunteer Application Form Please fill out the below form in order to register interest in becoming a volunteer. Volunteering InterestI am interested in* Appropriate Adults Accompanying Adults Befriending Mentoring Personal DetailsName* Forename Surname Address*Postcode*Email* Home phone numberMobile phone numberDate of birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Are you registered as disabled?YesNoPlease give details of any health treatment received over the past three years and any factors relating to your health that might affect your performance as a volunteerDo you hold a current Driving Licence?YesNoDo you have use of a car?YesNoEmployment DetailsPlease give details of employment starting with your current or, if not employed, most recent employerPlease state: Date employed from and to, Employer name, Job title/Nature of employment*Please account for any breaks in employmentEducation DetailsPlease give details, with dates, of secondary and further/higher education, in-service training, etc. including any qualifications gainedRelevant ExperiencePlease give details of your experience of working with young people/vulnerable adults, including voluntary workSupporting StatementPlease tell us why you would like to volunteer with your chosen project and any hobbies and interests relevant to the roleRefereesPlease give details of THREE people we may approach for a reference as to your suitability to become a volunteer. One should be your current or, if not employed, most recent employer. (Please note: family members or partners may not be used as referees)Referee #1 Name*Referee #1 Designation*Referee #1 Telephone*Referee #1 Email* Referee #1 Address*In what capacity and for how long have you known Referee #1?*Referee #2 Name*Referee #2 Designation*Referee #2 Telephone*Referee #2 Email* Referee #2 Address*In what capacity and for how long have you known Referee #2?*Referee #3 Name*Referee #3 Designation*Referee #3 Telephone*Referee #3 Email* Referee #3 Address*In what capacity and for how long have you known Referee #3?*How did you hear about this volunteering opportunity?DeclarationInformation Declaration* I declare that the information given on this form and in any accompanying documentation is to the best of my knowledge and belief correct. Consent* I give my consent to the Young Lives Foundation to process information and data relating to my application, including sensitive personal data, in line with the Data Protection Act 1998. This consent includes taking up references and obtaining an Enhanced Disclosure through the Criminal Records Bureau and a check with the Disclosure & Barring Service. CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.