Volunteer Registration

All volunteers at Willow Burn Hospice are required to complete online training. The team at Willow Burn will help to complete this so please don't worry. Please tick the box if you are happy to complete the training. If not, we will not be able to take the application forward at this time. If you are happy to do the training but need support please still tick the box and we will organise support.

First Name*

Last Name*

Address

Post Code

Email Address*

Phone*

Date of Birth*

Emergency Contact Details (Please give Full Name, Home Telephone No and or Mobile No, Relationship)

Which role are you applying for?*

Are you interested in any other roles? (Please select all that apply)

How often would you like to volunteer? (e.g. once a week. Please also note if you have limited availability during specific times i.e. term time)

Why would you like to Volunteer for Willow Burn Hospice?

Current/ Previous Employment/ Experience (please give brief outline)

Skills & Qualifications (Please tell us about the skills you have acquired from employment, previous volunteer work or through hobbies. Write N/A if not applicable)

Are there any particular skills you would like to develop by volunteering with the hospice?

Reference 1 (Please provide Full Name, Relationship to Referee, Email Address and/or Postal Address)

Reference 2 (Please provide Full Name, Relationship to Referee, Email Address and/or Postal Address)

Some volunteering position at the Hospice are subject to disclosure checks under the Police Act (section 5) and as a requirement of the Care Quality Commission. You will be required to provide original documentary evidence for proof of identity purposes should we require this check.

I understand I may be required to provide original documentary evidence for proof of identity purposes.

The provision of the Section 4(a) of the Rehabilitation of Offenders Act (exemptions) Order 1975 applies to all applicants other than those applying to volunteer in nursing/medical roles and roles involving access to children. If you are applying for a volunteer role in one of these categories you must disclose all of (or any) convictions, no matter where they occurred. Having a conviction will not necessarily stop you from volunteering, but will need to be taken into consideration when assessing your suitability. Have you had any court convictions other than spent convictions under the Rehabilitation of Offenders Act 1974 or are any proceedings pending?*

Yes
No

I understand my personal data will be used to process your submission, support your experience throughout this website, and for other purposes described in our privacy policy.

Please read and tick the box if you agree to the following. I certify to the best of my knowledge the information given on this form is correct. If accepted as a volunteer at Willow Burn Hospice, I agree to maintain the confidential information of the organisation and its service users (without any time limit). I consent to holding and processing of personal sensitive data provided by me to Willow Burn Hospice for all purposes relating to volunteering but not limited to administering and maintaining personal records. The processing of the data will be in accordance with GDPR . I am willing to complete the mandatory volunteering training passport.

I agree

Benefits of Volunteering?