START

Thank you for your interest in joining the team of volunteers for the Centre for Better Health.
Please complete the following application as thoroughly as you can.


Personal Details



Date of Birth (submit as dd/mm/yyyy):

Address




Borough:

Contacts



EDUCATION

Please provide details of your education history

Name of School attended:
Dates To/From:
Name of University / College attended:
Dates To/From:
Degree(s) Obtained:
Other Qualifications:

EMPLOYMENT AND VOLUNTARY WORK EXPERIENCE

Current Employment Status:

Current Employer:
Current Employer Address:
Position Held:

Relevant Work Experience (paid or voluntary)

Please give details of any paid or voluntary work experience relevant to this position.

Experience 1

Organisation:
Address:
Nature of work or position held:
Dates To/From:

Experience 2

Organisation:
Address:
Nature of work or Position held:
Dates To/From:

Experience 3

Organisation:
Address:
Nature of Work or Position held:
Dates To/From:

SKILLS AND EXPERIENCE

What are your practical skills and experience relevant to this type of work?
Which of your personality traits do you consider most suitable for this work?
What is your experience of working with adults with mental health issues?
Why do you wish to volunteer your time with The Centre for Better Health?
What do you hope to gain from your experience?:

AVAILABILITY

Please provide details of your availability.

When would you be available to start?
How many hours per week are you available to volunteer?
Please indicate which day(s) you are available?

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REFERENCES AND CHECKS

Note: Please be aware that an offer of a placement is based on satisfactory references and DBS checks

DBS check

Do you have any spent or unspent criminal convictions, cautions, reprimands or warnings? This volunteer placement is exempt from the Rehabilitation of Offenders Act 1974

Do you have any criminal convictions?:
Details of Criminal Convictions:
Do you already hold an enhanced DBS certificate, issued less than a year ago and to work with adults?:

References

Please provide the details of two referees.

Referee 1

Name:
Email:
Job title:

Referee 2

Name:
Email:
Job title:

OTHER INFORMATION:

How did you hear about us?:

This section is optional however by providing us with this information you will help us ensure that our services reach the widest possible audiences and that they are available to sections of the public that may be underrepresented.

Gender:
Gender - self description:
Ethnicity:
Ethnic Category- Other:

Religion or Belief:
Other Religion or Belief:
Sexual Orientation:
Other Sexual Orientation:

CONSENT

Thank you for completing this application, we use all information in accordance with the data protection act.

Kindly type your name below to consent to your information being processed by us.

Consent:

Please click here to access our policy about how your personal details will be handled.

You can withdraw your application at any time by emailing services@centreforbetterhealth.org.uk