Templesprings Volunteer Application Form

Volunteering Policy

Volunteering is the commitment of time and energy for the benefit of society and the community and it can take many forms. It is undertaken freely and by choice without concern for financial gain. It is an activity that involves spending time, unpaid, doing something that aims to benefit the community, individuals or groups other than close relatives.

Thank you for offering to give some of your time and experience to assist us. Templesprings recognises that the involvement of volunteers can enhance the work of our organisation.

We provide equal opportunities and are committed to the principle of equality regardless of age, disability, gender, race, sexual orientation, religion or belief. We will apply policies that are fair, equitable and consistent with your skills and abilities.

Templesprings takes responsibility for ensuring that volunteers within our organisation are involved in areas where they have the relevant skills, are fully inducted, are valued for their contribution and respected as individuals.

Position Applied For:

Name*

First NameLast Name

Gender

MaleFemale

Mobile Telephone*

Email Address*

Date of Birth*

Date

Address*

Please tick which applies*

Name of Current Employer or College*

Job Title or Course*

Ethnic Origin*

Hidden-Please tick which applies

White (British, Irish or other)Mixed (White and Asian, White and Black African)Asian (Asian British, Indian, Pakistani, Nepalese or other)Black (Black British, Black Caribbean, Black African, Black British or other)Eastern European (British, European, other)Chinese, (Chinese British, Chinese or other)

Professional Reference Full name*

First NameLast Name

Relationship*

E.g Manager, HR

Telephone Number*

Email*

example@example.com

Personal Reference Full name*

First NameLast Name

Relationship*

e.g Parent, Friend

Telephone Number*

Email*

example@example.com

Why do you want to volunteer with Templesprings?*

What experience do you have of voluntary work?*

What experience do you have in working with children and young people?*

What skills do you feel you can bring to Templesprings?*

Times for the opportunity: Please tick your availability in the boxes below*

	Mon	Tues	Weds	Thurs	Fri	Sat
Morning 9am - 12pm
Afternoon 12pm - 4pm
Evening 4pm - 7pm

1. Have you ever been treated for depression*

If yes, when was this and what treatment did you receive?

2. Have you ever attempted suicide?*

If yes, when was this and how did you attempt suicide?

3. Have you ever experienced violence?*

If yes, when and from whom?

4. Have you ever been violent?*

If yes, when and towards whom?

5. Have you ever suffered with any other mental health/ psychological problem?*

If yes, what was this , when was this and what treatment did you receive?

6. Have you ever been to see a psychologist, counselor, therapist or psychiatrist?*

If yes, when was this, how long were you receiving treatment and why?

7. Have you ever been admitted onto a psychiatric ward?*

If yes, when was this; how long were you an in-patient? Why were you admitted and which unit were you admitted to?

8. Are you currently in any form of therapy, counselling, psychological or psychiatric treatment?*

If yes, 1) why are you receiving treatment; 2) since when have you been receiving treatment; 3) who is treating you and 4) what is their contact details?

1. Do you smoke?*

If yes, how many per day?

2. Describe your alcohol consumption?*

NeverOccasional (several times a month)Sometimes (2-3 times weekly)Often (more than 3 times a week)

3. Do you use any drugs other than prescribed medications?*

If yes, what drugs and how often

4. How often do you exercise?*

NeverOccasional (several times a month)Sometimes (2-3 times weekly)Often (more than 3 times a week)

Signature*

Clear

Templesprings Registered Charity Number 1125084

Volunteer Application Form

Volunteer Application Form

Personal Information

Employment /Educational Status

Ethnic Origin

References & DBS Checks

Volunteering

Psychological Wellbeing and General Health

Signatures