Volunteer Application Form

Section 1 – Personal Contact Details

First Name

Last Name

Email

Telephone

Address (including Postcode)

Section 2 – Emergency Contact Details

First Name

Last Name

Email

Telephone

Address (including Postcode)

Relationship of contact

Volunteer Roles

Requested Role (Please indicate) Requested Role (Please indicate) Library Rooted Coffee House

Please tell us why you would like to volunteer in the library or coffee shop and any relevant skills, experience or interests you have.

Do you have a disability or specific need for special arrangements or adjustments that are needed for the role or the interview? We treat all information in the strictest confidence but we may need to discuss your requirements

Section 3 – Availability

How much time do you have available to volunteer? Please give the number of hours/days per week. Volunteering is usually 2 hours each time. For Work Experience Tues-Fri full days and Sat half day. For Duke of Edinburgh 1 hour per week for 6 months.

Please indicate your preferred times for volunteering:

Weekday Weekday Tuesday AM Tuesday PM Wednesday AM Wednesday PM Thursday AM Thursday PM Friday AM Friday PM

Weekend Weekend Saturday AM

Preferred start date (DD/MM/YYYY)

Section 4 – Referees

Please give the name and contact details of two people who we can contact for a reference (not family members), if possible, one should be a professional or work-related reference. Please note that we will contact these referees prior to the start of your volunteering. If you are under 18, please provide ONE referee (which can be a school teacher)..

First referee

Name

Relationship

Telephone

Email

Second referee

Name

Relationship

Telephone

Email

Section 5 – Data Protection Statement

The information that you provide on this form and that obtained from other relevant sources will be used to process your application for volunteering at Blackfen Community Library. I understand that my data will be held and treated in accordance with the Blackfen Community Library Privacy Policy. The information that you provide on this form and that obtained from other relevant sources will be used to process your application for volunteering at Blackfen Community Library. I understand that my data will be held and treated in accordance with the Blackfen Community Library Privacy Policy. I agree that Blackfen Community Library can hold my data.

Section 6 – Self Declaration Statement

Self Declaration Agreement – Blackfen Community Library is committed to the safeguarding of children and vulnerable adults. I understand that before I become a volunteer I will need to read, sign and date a self declaration form. Self Declaration Agreement – Blackfen Community Library is committed to the safeguarding of children and vulnerable adults. I understand that before I become a volunteer I will need to read, sign and date a self declaration form. I understand and agree to the terms

Dated (DD/MM/YYYY)