Leader Application Form

Leaders Form

Please complete this form if you have been provisionally accepted as a leader for one of our trips
Your Name:*

First NameLast Name
Date Of Birth *

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (+44)*

Area CodePhone Number
Email*
example@example.com
Passport Information
Passport Number*
Passport Expiry Date*

MonthDayYear
Date
Passport ID Photocopy

Please upload a copy of your ID Page
Browse Files

Cancelof
Employment Details
Name of Current Employer*
Name*
Please enter a contact name for reference purposes
Email*
Please enter the organisations email
Phone Number (please enter the organisations phone number including extensions)*

Area CodePhone Number
Website (please enter organisations website URL) *
Length & Details Of Service*
Please let us know how long you have been at the organisation and what your role and responsibilities are within the organisation
Leadership Experience

Please can you let us know about your previous leadership experience in working with young people
Experience*
Referee*
This is someone who can vouch for your leadership ability
Referee Email*
Special Dietary / Disability Requirements

Please inform us of any additional needs. Thank you
Safeguarding Information
Do you have a current DBS Certificate ?*

YesNoWaiting
Cautions Or Convictions

Because this project involves working with young people under the age of 18 and vunerable adults, the proccess of applying to become a volunteer is exempt from the provisions of section (42) of the Rehabilitations of Offenders Act 1974 By the virtue of the Rehabilitataions of Offenders Act 1974 (exceptions) order 1975. This means that you may not withhold any information about convictions which for other purposes are "spent" ( or otherwise "unspent") under the provisions of the Act. In the event of a successful volunteer application, any failure to now disclose such convictions could lead to disciplinary actions being taken and/or the dismissal/refusal of your application
YesNo
If "Yes" Please give details*
Signature *
Should be Empty:

Leaders Form

Passport Information

Employment Details

Leadership Experience

Special Dietary / Disability Requirements

Safeguarding Information