Volunteer Application - DOC 3 by Fzd4JI

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Volunteer Application                                                                                                        Crb:
                                                                                                                             Conf:
Pegasus Playscheme
It is vital that you read all of the questions: Your place cannot be guaranteed unless all of the questions are completed:

Contact Information:

Name

Address



Postcode
Home Phone
Mobile

E-Mail Address

Date of Birth
Age at Scheme
Ethnic Origin
Do you have a
particular age range
you would prefer to
work with
Children are aged
between 8yrs to 25yrs

Have you volunteered
at Pegasus before
Do you have any
special health
requirements
                                           Availability
Name of Volunteer:


                                     Dates for Pegasus 2012

                             Monday 23rd July – Friday 10th August
                                      Monday – Friday
                                     9:15am – 3:45pm

The expectation is that volunteers attend every day, however we appreciate that you may
have a planned pre-existing appointment, in which case, please detail this below:

                      Date unable to Attend                   Reason




…………………………………………………………………………………………………………

                                         CRB Checks
A CRB is Criminal Record Check.
As a volunteer at Pegasus you are never left alone with a child therefore a CRB check is not
essential. However, if you are planning to apply for jobs / college courses working with young
children a CRB will be an excellent advantage to your CV.

Pegasus are more than happy to subsidies the £32 a CRB would cost you. We will charge just £10. If
you would like a CRB please sign below and send a cheque for £10 made payable to ‘Pegasus
Playscheme’ along with your application form. You must have 3 forms of ID for the CRB to be
carried out, these will be requested at a later date.

(NB: If payment is not included your CRB check will not be carried out)


I would Like a CRB check and payment is enclosed:

Signed: ……………………………..

Date:………………………………..
To ensure your application is processed: ALL OF THE QUESTIONS MUST BE COMPLETED:

Name of Volunteer:


Special Skills or Qualifications
Please summarise any special skills, experience and qualifications that you have acquired from school,
previous volunteer work, including sports or hobbies.




Emergency Contact Details:
Name
Relationship to
volunteer
Address

Postcode
Home Phone
Work Phone
Mobile

E-Mail Address

Doctors Name &
Address.
Must be completed fully
inc telephone Number


Agreement and Signature
By submitting this application, I confirm the facts are true and I also agree to a non smoking policy and to wear my seat belt at all times.
I understand that if I am accepted as a volunteer, I will agree to Pegasus Play scheme’s Code of Conduct.
Name (printed)
Signature
Date
I consent to any emergency medical treatment including operations under general anesthetic, as may be
recommended by a qualified medical professional

Volunteers under the age of 16yrs must have this form signed by a parent
Name (printed)
Signature
Date

Our Policy
It is the policy of this organisation to provide equal opportunities without regard to race, colour, religion, national origin, gender, sexual
preference, age, or disability. We operate to Ofsted standards and as such have a full complement of policies available to view upon
request.

Thank you for completing this application form and for your interest in volunteering with us.
If you have any questions please feel free to contact me.07789696358
Please return to Kim Bladon
kimanddave@btinternet.com
Or Post to
Pegasus Playscheme
Ambleside
Collingwood Rd
St Margarets-at-Cliffe
CT15 6EX
 Pegasus Play Scheme is a registered charity (No. 299301) whose objects are to provide play and recreational opportunities to children
                                 and young people with learning difficulties in the Dover/Deal area

								
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