Download Volunteer application form

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Download Volunteer application form Powered By Docstoc
					Download Volunteer application form
Nightstop undertakes to keep confidential any information given by the applicant for the purposes of this application, except where it is necessary to pass on information to statutory vetting agencies. A separate form will be used for these agencies. q host q other (please state) q driver

1: names of those normally resident in the house: full name normally known as relationship date of birth

2: please mention here any of the above who is not willing to take part in The work with nightstop: full name normally known as relationship date of birth

3: present address: address

home telephone number mobile telephone number 4: may we ring you at work? Yes / no 5: what experience do you have relevant to the nightstop role envisaged?

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6: have you any particular experience or knowledge helpful to certain Groups of young people (e.g. foreign language such as Urdu, caring for Disabled person, etc)?

7: why do you wish to volunteer for nightstop?

8: is there anything that we should know about you, or need to do, to help you with your application or volunteering? (for example, you may have poor vision, or trouble with stairs) 9: would prospective hosts please confirm that a private bedroom is available for a young person: q yes q no q not applicable

10: please give below the names and details of two people who have known you for at least a year, at least one of them must have knowledge of your family / household. under “position” enter, for example, close friend, employer, and work colleague as appropriate.

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name of referee (1) address home telephone number mobile telephone number email position name of referee (2) address home telephone number mobile telephone number email position 11: signature of each person in the household participating in nightstop: full name signature date

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equal opportunities monitoring form
Nightstop is committed to eliminating discrimination, promoting good relations and equal opportunity of access to our services and so, we would be grateful if you would answer the following questions. This information will be used to help us provide a better service, but you do have to answer every question. just leave the questions that you do not wish to answer. All information given will be treated in the strictest confidence. I am I am I define my race as (tick only one) I define my ethnic origin as  male  16 –18  19 – 25  black  mixed race  African  Caribbean  south east Asian I define my sexuality as: (tick only one) Do you consider that you have a disability?  lesbian / gay  other (please state) yes / no if yes, please state  female  26 – 30  31 – 45  white  other (please state)  Asian  European  other (please state)  bisexual  heterosexual  I do not wish to answer  I do not know  British  Irish  46 – 59  over 60

Office: Unit 5 Beresford Court, Beresford Lane, Ayr KA7 2DW Tel: 01292 288873 Fax: 01292 265394 Email: sanightstop@aol.co.uk
Nightstop is a registered Charity No.Sco35824

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volunteer confidentiality
A volunteer of nightstop may in the course of his / her duties have access to a considerable amount of personal information relating to young people. It is expected that all volunteers understand the importance of treating information in a discreet and confidential manner. Any information about young people must not be disclosed without the permission of the project manager and with the agreement of the person concerned. Any breach of confidentiality could have serious consequences for the person concerned. Confidential information must not be disclosed to any unauthorised person both during and after your involvement with the nightstop project. All staff and volunteers of the nightstop project will be asked to agree and abide by the confidentiality policy, which they will be asked to sign. A copy will be kept as a record. Volunteers will find more details concerning confidentiality enclosed within the host family guidelines.

statement of confidentiality

Host families are in a unique position of responsibility due to the personal nature of the relationship they establish with young people, who may be especially vulnerable. As a host family with nightstop you will appreciate the importance of treating with great care any information in respect of the young people on the scheme. However, young people need to understand that if they do tell you something that is of a serious nature (e.g. which indicates that they or others may be at risk) you will need to contact the project worker. This ensures that, as far as possible, young people and others can be protected. I have read and understood the above. I agree to respect any information given to me concerning young people referred to nightstop. signed: print name: date:

Office: Unit 5 Beresford Court, Beresford Lane, Ayr KA7 2DW Tel: 01292 288873 Fax: 01292 265394 Email: sanightstop@aol.co.uk
Nightstop is a registered Charity No.Sco35824


				
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