Volunteer Application Form (Shops)

Please fill in this form if you are applying to be a volunteer in one of our CHARITY SHOPS.

If you wish to apply to volunteer at the HOSPICE please fill in the Volunteer Application Form (Hospice)

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
	Telephone number
	Mobile telephone number
	Email address
	Age if under 18
	Emergency contact name
	Emergency contact telephone number
	Which type(s) of volunteer duty are you interested in?	in the shops on the furniture van
	What is your current occupation?
	Have you done voluntary work before? (please give details)
	Why do you want to become a volunteer for St. Rocco's?
	How did you hear of volunteering opportunities at St. Rocco's?
	Do you have any 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 criminal convictions?* (Please give details)
	* You need not declare spent convictions. All information will be treated in the strictest confidence. Previous convictions will not necessarily bar you from becoming a volunteer.
	Do you have any other skills which you think would benefit the hospice?
	Where would you prefer to work?
	Please indicate the days which you would be willing to work	Monday Tuesday Wednesday Thursday Friday Saturday
	Please indicate the times you would be willing to work	morning afternoon all day
	Please give details of 2 referees (these must be over 18 and not relatives)
	Title
	Referee 1 Name
	Referee 1 Address
	Referee 1 Address Line 2
	Referee 1 Address Line 3
	Referee 1 Postcode
	Referee 1 Telephone Number
	Title
	Referee 2 Name
	Referee 2 Address
	Referee 2 Address Line 2
	Referee 2 Address Line 3
	Referee 2 Postcode
	Referee 2 Telephone number
	Date of application