Which area of work are you interested
In volunteering for, i.e. youth work,
gardening, working with children, office work
Are you employed at the moment?
Yes/No
Have you done voluntary work before?
Yes/No
What experience have you had that you think would be beneficial to your chosen area of
volunteering?
What days would you be available to volunteer for work?
Tuesday Thursday Friday
PERSONAL DETAILS
Your Name
Male / Female (please delete as
appropriate)
Address
Postcode
Age
Date of Birth
Home Phone
number
Your Mobile
number
Email address
Emergency
Contact Name
Emergency Contact
Number
BLABY DISTRICT COUNCIL
VOLUNTEER APPLICATION FORM
Equal Opportunities
(Please Circle appropriate option)
Mixed
White
Other
White & Black
White & Asian
Other
British
Irish
Other
Gypsy
Traveller
Asian or Asian British
Black or Black British
Chinese
Indian
Pakistani
Bangladeshi
Other
Black
Black
British
Black
Other
Chinese
Please detail if you have any medical conditions, allergies, learning difficulties and/or
disabilities
CONSENT
This form has been explained to me. I understand that the information collected will be used to help
plan and deliver better services and the personal information contained on it will be processed by
Blaby District Council in accordance with the Data Protection Act 1998 and it may be shared with
other departments of the District Council and outside bodies where necessary. The information
provided will not be shared with organisations for marketing or sales purposes. An enhanced
Disclosure and Barring Service check may be required to ensure the suitability of applicants who
may be volunteering to work with young people or vulnerable adults.
I understand the information will be held in accordance with the Council’s records management and
retention policy.
I understand that some of the information requested requires my explicit approval and by providing
the information I agree that Blaby District Council can use the information for statistical purposes to
assess effectiveness in providing services.
Signed …………………………… Print Name ……………………………... Date ……………
PLEASE RETURN SIGNED FORM TO: Blaby District Council, Health & Leisure
Services, Council Offices, Desford Raod, Narborough, LE19 2EP
or email leisure@blaby.gov.uk
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome