Volunteer or Mentor | 1625 Independent People Bristol Charity : 1625 Independent People

1. Contact Information

If you have any questions, or would prefer this form to be emailed or posted to you, please email volunteering@1625ip.co.uk

Volunteering post(s) you are interested in:

How did you hear about us?

Full name*

Address

Street Address Address Line 2 City County Postal Code

Daytime telephone number

Evening telephone number

Email address*

Date Of Birth*

2. SKILLS AND EXPERIENCE

Please state any skills, qualifications, training or experience (including lived experience) that may be relevant to the volunteering you want to do.

Please tell us the days / times you are available to volunteer and about any commitments that will restrict your volunteering e.g. childcare, courses or work

3. REASONS FOR VOLUNTEERING

Please tell us why you want to volunteer with 1625 Independent People

Please tell us what type of volunteering you are interested in at 1625 Independent People

4. References

Please provide two referees. In absence of a professional, employment or educational referee we can accept a reference from a support worker or character reference (excluding friends and family members)

Reference 1 - Name

Reference 1 - Position and relationship to you

Reference 1 - Address

Street Address Address Line 2 City County Postal Code

Reference 1 - Telephone Number

Reference 1 - Email

Reference 2 - Name

Reference 2 - Position and relationship to you

Reference 2 - Address

Street Address Address Line 2 City County Postal Code

Reference 2 - Telephone Number

Reference 2 - Email

5. CONVICTIONS

We want to ensure that our workers, volunteers and clients are not placed at risk. As 1625 Independent People meets the requirements of exempted questions under the Rehabilitation of Offenders Act 1974, certain roles may be required to undergo a check from the Disclosure and Barring Service (DBS). Offences do not necessarily mean that your application will be turned down. We give careful consideration to providing opportunities for ex-offenders.

Have you ever been formally cautioned or convicted of a criminal offence?*

Yes
No

If 'yes', please give details including the date(s) of the caution or conviction and provide as much detail as possible.

6. DISABILITY / Access Requirements

Please let us know if you have a disability and/or if there are any reasonable adjustments we can put in place to support you to volunteer (e.g. large print, induction loop, wheelchair access)

7. Volunteering Diversity and Inclusion Monitoring

We are committed to make sure all our Volunteers are not discriminated against on the grounds of protected characteristics. By providing information about yourself, you will help us adhere to equal opportunities best practice and to identify any barriers to diversity among our volunteers. You do not have to answer all the questions but the more information you give, the more effective we can be. All information is treated in the strictest confidence.

Ethnic Origin?*

Gender

Gender Identity

Sexual Orientation

Age Group

Disability

Disability Definition The Equality Act 2010 states “A person has a disability if they have a physical or mental impairment, which has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities.” We fully support the social model of disability and we recognise that people with different impairments or medical conditions can experience different barriers.

If you have ticked 'two or more conditions', please state these:

Religion

If you have ticked 'any other religion or belief', please state:

Declaration*

I confirm that the details I have given in this application are accurate. If my application is successful I understand that any false statement or failure to disclose information may result in the end of any position offered to me.

I Confirm