Volunteer Application Form Personal Details Name Title Address Postcode Home Phone Work Phone Mobile Date of Birth Email Address Volunteering Opportunities Please select one or more roles: Sight Matters News ServiceAdministrationReaderReceptionCopierFundraisingDispatcherAudio LibraryLunch GroupsDrivingBefriendingMinibus EscortMinibus Driver (25+)EntertainerSports ActivitiesGardeningWalkingDIY / Basic MaintenanceShootingCateringBowlingIT TrainerTandem BikeGuide Dog WalkerShop / Retail AssistantGuide Dog BoarderDelivery Driver Availability Please tell us your availability Your Health Do you suffer from any health conditions that may affect your volunteering? NoYes If yes, please provide details Personal Interests & Experience Please list your interests, experience, qualifications or skills Driving Do you hold a full clean driving licence? YesNo Have you had a driving accident in the last five years? YesNo Are you prepared to transport members in your own car? YesNo Would you be willing to drive the Society’s minibus or car? YesNo Convictions Have you ever been convicted of a criminal offence (excluding minor motoring offences)? NoYes Have you ever been involved in any investigation or enquiry into abuse or inappropriate behaviour? NoYes Emergency Contact Name Phone Relationship Communication Preferences Yes Post Yes Phone Yes Email Yes Text Message Agreement I confirm that the information provided is true and I understand the responsibilities regarding confidentiality. I consent to Sight Matters storing and processing my personal data for the purpose of my volunteer application. Name (printed) Date References Reference 1 – Name Reference 1 – Address Reference 1 – Relationship Reference 2 – Name Reference 2 – Address Reference 2 – Relationship
