Are happy for your information to be held in the volunteer database for any future opportunities.
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Your information will be kept for this reason only and you can request to be removed from the database at any time by emailing info@21together.org.uk
Name
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First Name
Last Name
Email
*
Phone Number
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Home Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Date of birth
*
MM
DD
YYYY
How are you interested in supporting?
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Tick all that apply
How long are you able to commit to volunteer?
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This is a rough idea, but allows us to plan accordingly in the best interests of the children.
Do you have any previous experience working with children or young people with disability?
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Please detail any experience you have.
Why would you like to volunteer with the sessions?
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Current place of work/study if any
Name of reference one
*
Current / Most recent work / study area if possible.
First Name
Last Name
Reference one relationship to you
*
Email to contact reference
*
Name of reference two
*
If this a personal reference it must be a professional person such as teacher, soliciter, health professional or similar.
First Name
Last Name
Reference two relationship to you
*
Email to contact reference two
*
Please choose the most relevant option
*
Do you have any convictions, cautions, reprimands or final warnings which are not protected as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)?
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If you have answered yes, you now have two options on how to disclose your criminal record. Option 1: Please provide details of your criminal record in the space below. Option 2: You can disclose your record under a separate cover provided that you mark a cross on the line below and attach the details in an envelope stapled to this form. The envelope should be marked CONFIDENTIAL and state your name and the details of the post.
