Title: Mr Ms Other Name: Address: Post Code: Date of birth (mm/dd/yyyy): Telephone: Email (if you have access): Are you interested in any particular type of volunteer role(s)? E.g. adviser, administrator, social policy co-ordinator, trustee board member. Describe any skills you have that would be useful for the role you wish to do. Some we have thought of include: dealing with people face-to-face or on the phone, speaking/writing a language other than English, sign language, filing, research, using a calculator, using a computer, helping people to learn. Is there anything you have done over the past few years that you would like to tell us about? e.g. employment, work experience, volunteering, community activity (involvement in tenants associations, school activities, support groups, etc); caring for children, other relatives or a friend; classes, training courses. Why do you want to volunteer for CAB? What do you hope to get from the experience? What do you think are some of the main problems facing your community? It is useful to know when you will be available to volunteer. Please indicate below the times when you are generally available: Please indicate approximately how many hours or days per week you would like to volunteer for: Are there any times that you are unlikely to be available, e.g. school holidays? Is there anything else you would like to say about yourself? Volunteers who wish to train as advisers only: Have you ever committed an offence under section 25 and 26 (1) (d) or (g) of the immigration act 1971? (These offences concern assisting illegal entry, falsifying documentation or obstructing the authorities investigating immigration offences. If you have committed one of the offences above you may still be able to be an advisor: however, we would have to contact the Office of Immigration Services Commissioner in order to discuss the issues.) Please tick as appropriate. Referee name: Address: Post Code: Referee name: Address: Post Code: We may wish to contact them before an interview. May we have your permission to do this? Your application will not be affected if you say no: Please tell us about any specific needs you would like us to take into account, either at the interview or if we offer you a volunteer role: e.g. mobility, childcare responsibilities. This information will be treated as strictly confidential. Age: Gender: Would you describe yourself as being disabled? Ethnicity (White): Ethnicity (Mixed): Ethnicity (Asian or Asian British): Ethnicity (Black or Black British): Ethnicity (Chinese or other ethnic group): What prompted you to apply to be a CAB Volunteer?: Data Protection Act 1998. As part of the recruitment procedure we may collect and store sensitive personal data about you. We are required by law to obtain your consent to such data being recorded. It is our policy to store data relating to recruitment procedures for up to a year after the date on which it is submitted. Any information of this nature will be treated confidentially. Sensitive personal data is defined as information relating to any of the following: racial or ethnic origin, political opinions, religious beliefs, trade union membership, health, sexuality or sex life, offences and/or convictions. I declare the information given on this form is correct to the best of my knowledge and acknowledge that by signing this form I have given my consent to sensitive personal information being recorded and stored.
