Volunteering

Volunteer Application Form (Hospice)

Please fill in this form if you are applying to be a volunteer at the HOSPICE.

If you wish to apply to volunteer in one of our CHARITY SHOPS please fill in the Volunteer Application Form (Shops)

If you do not wish to fill in an online application please click here

Your details

Title

First name *

Surname *

Address Line 1

Line 2

Line 3

Postcode

Contact Telephone number

Mobile telephone number

Email address

Date of birth if under 18

Emergency contact name

Emergency contact telephone number

Which type(s) of volunteer duty are you interested in?

What is your current occupation?

Why do you want to become a volunteer for St. Rocco's?

Have you done voluntary work before? (please give details)

How did you hear of volunteering opportunities at St. Rocco's?

Do you have any other experience which you think would be relevant to this role?

If you have had any serious operations or illnesses or are disabled this will not bar you from volunteering, but please tell us about them so we can accommodate them

Have you suffered a bereavement of a close relative or friend in the past 12 months? ( please give details)

Do you have any convictions other than minor traffic offences?* (please give details)

Do you have any objections to a check being made?

yes
no

*Due to the nature of this type of voluntary work, it is exempt from the provisions of the Rehabilitation of Offenders Act 1975 (Exemption) Order 1975. This means that applicants are NOT entitled to withhold information of convictions which, for other purposes, are spent. Previous convictions will not necessarily prevent you from becoming a volunteer.

Would you be prepared to help with occasional fundraising?

yes
no

Do you have any other skills which you think would benefit the hospice?

Please indicate the days you would be willing to work

Please indicate the times you would be willing to work

morning
afternoon
evening

Please give details of 2 referees (these must be over 18 and not relatives)

Title

Name

Address

Line 1
Line 2
Town
County
Postcode
Country

Telephone number

Title

[2] Name

[2] Address

Line 1
Line 2
Town
County
Postcode
Country

[2] Telephone number

Date of application

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