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Volunteer Application Form by 3iw5r9


									     NHS Greater Glasgow & Clyde Volunteer Application Form

If you are completing this form electronically, point your mouse arrow on to the highlighted portions OR use your tab
key to move between the highlighted fields and start typing. If appropriate ensure that you insert the Reference Number
on each page in the space provided. You must fully complete each section of the application form; the voluntary
services manager can support you to complete this form.

     Please only complete this form if you are applying for a volunteer role
     Volunteer Role:                                                                                 Section A

     Location:                                                                     Reference No
                                                                                   if applicable

     Fair Treatment Statement.
     In addition to its legal obligations under the Equality Act 2010, NHS Greater Glasgow and Clyde's
     Equality Scheme 2010-13 indicates that its key values are inclusion, diversity and equality for all.
     NHS Greater Glasgow and Clyde seeks to give full expression to these values and no volunteer
     will be unfairly discriminated against.
     Personal Details              lease use BLOCK LETTERS when filling in details)
     Title:                         Name known by (if different)
     Contact Details
     Address:                                                                    Telephone Numbers
     City/Town:                                                        Mobile:
     Post Code:
     What is the best way for us to contact you:
     Emergency Contact Details
     Name:                                                        Relationship:
     Telephone Number:        Daytime                                   Evening
NHS Greater Glasgow & Clyde Volunteer Application Form
Volunteer Role:                                                                                   Section 2

Location:                                                           Reference No
                                                                    if applicable

Personal Profile
You are only required to complete this section if the volunteer role you are applying for
involves driving
                             Do you hold a full driver’s license?         Yes        No

                                             Do you own a car?            Yes        No

      If Yes, are you interested in becoming a volunteer driver?          Yes        No

Availability                 (Place an X in the appropriate boxes)
                  Monday     Tuesday    Wednesday     Thursday           Friday     Saturday       Sunday



                                                                                               Section 2
Employment Status

Employed full time        Employed part time      Retired 

Unemployed                Student                  Other    

Carer 

Have you previously worked for the NHS?

Yes          No
NHS Greater Glasgow & Clyde Volunteer Application Form

Volunteer Role:                                                                    Section 2
Location:                                                         Reference No
                                                                  if applicable

Personal Profile
Have you previous experience as a volunteer?          Yes         No
If Yes, please give details:

Effective volunteer relationships and Peer Support are built on good interpersonal
relationships, in order to support our vulnerable patients please tell us how you think your
personality, interests, hobbies, skill or experience would meet our requirements

Why do you want to volunteer?

Please detail below any special or additional needs required to support you as a volunteer.

Volunteer Role:                                                                    Section 2
NHS Greater Glasgow & Clyde Volunteer Application Form

Location:                                                      Reference No
                                                               if applicable

Personal Profile

Please give details of any relevant training/experience with

Children: Yes       No

Older People: Yes        No

Mental Illness, Learning or Physical Disability: Yes   No

Any voluntary organisation: Yes        No

Volunteer Role:                                                                Section 3
NHS Greater Glasgow & Clyde Volunteer Application Form

Location:                                                                 Reference No
                                                                          if applicable

Footnotes and Declarations

1: Are you a United Kingdom (UK), European Community (EC)
                                                                       Yes                No
or European Economic Area (EEA) National?
2: If ‘no’ to above, please provide information below that relates to your current immigration/ visa
status. This status will be subject to checking after interview and before placing you in a voluntary role.

Please supply details of any permit currently held, including number, validity and expiry date

Footnote (1)
The Rehabilitation of Offenders Act 1974 - provides for many people who have been convicted of certain
criminal offences the opportunity to have no need to refer to these convictions or the circumstances relating
to them in the course of their daily lives. Certain convictions can, therefore, be regarded as “spent” after
the lapse of a period of years under the terms of the Act.
NHS Scotland is exempt from the Rehabilitation Of Offenders Act 1974 (Exclusions & Exceptions)
(Scotland) Order 2003. This means that you must tell us about any previous convictions either classed as
‘spent’ or ‘unspent’.
Having a criminal record will not necessarily debar you from volunteering with NHS Greater Glasgow &
Clyde. This will depend on the nature of the position, together with the circumstances and background of
your offences. If you are offered a volunteering position, any failure to disclose such convictions could
result in withdrawal of the volunteer placement. . Any information you give will be considered only in
relation to the post for which this application form refers.

                         Information will be verified by Disclosure Scotland.
Convictions                   (Place an X in the appropriate box)

I declare that I have:        (a) No Convictions
                              (b) Previous Convictions – Details of which I give below

Date         Offence                                 Sentence

Volunteer Role:                                                                                   Section 3
NHS Greater Glasgow & Clyde Volunteer Application Form

Location:                                                                     Reference No
                                                                              if applicable

Footnotes and Declarations
Please supply details of two (2) referees who have known you for over one (1) year, suitable
referees would include: work colleagues, former teachers, employers, ministers of religion, club
officials, neighbours, support workers and should be able to comment on your background and
suitability for the post. You should NOT use family members.
Correspondance to referees will be by e-mail, please ensure you have included a
current e-mail address for each referee
An Occupational Health check will also be required as part of the volunteer selection process

                     Referee (1)                                                Referee (2)
      Name:                                                     Name:
Designation                                               Designation
    Address:                                                  Address:

        City:                                                      City:
   Postcode:                                                  Postcode:
  Telephone:                                                 Telephone:

        Email:                                                     Email:
Please indicate which type of reference this will be      Please indicate which type of reference this will be

Character        Employer          Other               Character        Employer         OtherOtherv       Cha
The definition of ‘disability’ under the Equality Act 2010

In the Act, a person has a disability if:

       they have a physical or mental impairment
       the impairment has a substantial and long-term adverse effect on their ability to perform normal day-
        to-day activities

For the purposes of the Act, these words have the following meanings:

       'substantial' means more than minor or trivial
       'long-term' means that the effect of the impairment has lasted or is likely to last for at least twelve
        months (there are special rules covering recurring or fluctuating conditions)
       'normal day-to-day activities' include everyday things like eating, washing, walking and going

People who have had a disability in the past that meets this definition are also protected by the Act.

Volunteer Role:                                                                                       Section 3
NHS Greater Glasgow & Clyde Volunteer Application Form

Location:                                                                    Reference No
                                                                             if applicable

Footnotes and Declarations

Footnote (2)
Data Protection Act 1998

In processing any personal information or data we hold about you we will comply with the requirements of
the Data Protection Act 1998 (the “Act”). In particular all reasonable steps will be taken to ensure data is
processed fairly, kept secure, protected against loss or damage & only disclosed (unless required by law or
legal process) on a need to know basis. Under the Act you are entitled to ask us in writing to provide copies
of certain data we hold about you, upon payment of the appropriate fee.

I have completed Sections 1 to 4 of this volunteer application form and the details I have supplied are, to
the best of my knowledge, true and complete;
I understand that if appointed to this voluntary position the information on this form will be kept as part of
my volunteer personal file record;
I authorise NHS Greater Glasgow & Clyde to obtain references in support this volunteer application.
I consent to my details being kept confidentially and used for specific and lawful purposes as specified in
the Data Protection Act 1998;
I declare that I have no previous convictions, or have identified any I have above.
Read, agreed and understood (check box)

Signature:                                                                  Date:

To help us improve our service, please indicate where you heard about our volunteering
         Through a friend               From your family           Through a volunteer
             In a newspaper                           On television                          On the internet
                On the radio                 Picked up a brochure                 While visiting a patient
  From a Volunteer Centre                              Faith Group                       Through your club
          From your Doctor            Other (please indicate):

Please return this application form by post to the address below or email to
quoting the reference number and closing date.

If you are posting this application form by mail please ensure you have paid sufficient postage to:

Application Forms
NHS Greater Glasgow and Clyde Recruitment Service
5th Floor, Tara House
46 Bath Street
G2 1HJ
NHS Greater Glasgow & Clyde Volunteer Application Form

General guidance

        If you have any questions or would like some assistance in completing the form, please call Bryan
         Bannerman 0141 201 5310 (Adult Services) or Diane McCloskey 0141 201 0752 (Children’s Services)

        If you are using the ‘hard copy’ version of our application form, please use black ink and write clearly in
         BLOCK CAPITALS. This makes the form much easier to read.

        The people who look through your completed form (short listing or short listing team) will be looking to see if
         your skills and abilities match the requirements needed for the volunteering position.

        Please do not send in a CV instead of, or as well as, the application form. We do not consider CVs during the
         selection process for volunteers.

        Please fill in all sections of the application form. If some parts are not relevant, write ‘not applicable’ or ‘N/A’ in
         that space

        If you need more space to complete any section, please use extra sheets of paper.


If you do not hear anything further within 6 weeks of the closing date for the position, your application
has been unsuccessful on this occasion and you will receive no further correspondence. This should not
deter you from applying for a volunteer position in the future or in a different part of the organisation.


Personal Details

        This gives us your contact details such as name and address. Under ‘title’ you would put either Mr, Mrs, Ms,
         Dr or just leave blank if you prefer
        We may need to contact you at some time throughout the recruitment process. Please let us know the most
         suitable method of contacting you, for example a text message, email or phone call and, the most convenient

Working/volunteering in the UK

        It is important that this section is completed accurately. If you are unsure please contact the Recruitment
         Service on 0845 3000831.


        This information is confidential between the volunteer and the Occupational health Department; it will be used
         to determine if you are fit to undertake the tasks highlighted in the volunteer role description.

Footnotes and Declarations

        You must tell us about all convictions and cautions regardless of how long ago the offence may have
         occurred. Convictions from other countries must also be notified. If in doubt please call the Recruitment
         Service on 0845 3000831.
        Normally you would be exempt under the Rehabilitation of Offenders Act 1974 from disclosing ‘spent’
         convictions or cautions; however this is not the case when applying for jobs within the NHS. You must
NHS Greater Glasgow & Clyde Volunteer Application Form
       disclose any convictions or cautions. Shortlisting managers do not have access to this information and only if
       you were being called for interview would the manager see this information.
      Please note that having a conviction will not automatically disqualify you from volunteering with us. Careful
       consideration will be given to the relevance of the offence to the particular position in question. However, if
       you are appointed, and it is found that you did not reveal a previous conviction your voluntary position may be
      Remember to read, consider and sign the declaration at the bottom of page 2.

References Section

      Referees are people who know you well. Please give the full names and addresses of 2 referees, one of
       whom can be your present or most recent employer, but generally character references are suitable for
      You should check that the people you have put on your form are happy to be referees.
      Where possible include an email address for your references – this can make the process considerably
      Your referees will not be contacted unless you are a ‘preferred candidate’ after interview. A preferred
       candidate is someone who is the preferred choice for the volunteer position, subject to satisfactory checks
       where appropriate.

Driving Licence

      You only need to complete this if the job requires you to drive. If you need advise re this please call Bryan
       Bannerman 0141 201 5310
Why do you want to volunteer?

      This is one of the most important parts of the form. In here you say why it is you want this position, and can
       list all your skills and abilities and experience that you think help to match you against the ‘volunteer role

Where did you see the advert section

      Please try to remember where you heard about this position, and tick the relevant box. The information you
       give will help us find out how good our advertising is

                           Please send the completed form to the following address:

Application Forms
NHS Greater Glasgow and Clyde Recruitment Service
5th Floor, Tara House
46 Bath Street
G2 1HJ

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