Name
*
First Name
Last Name
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone Number
*
Emergency Contact Name #1
*
First Name
Last Name
Emergency Contact Number #2
*
Emergency Contact Name #2
First Name
Last Name
Emergency Contact Number #2
Employment Status
*
Full Time
Part Time
Unemployed
Retired
Other
I Have Voluntary Experience
*
No
Yes
Have you ever been convicted by the courts or cautioned, reprimanded or given a final warning by the police?
*
No
Yes
Have you recently submitted a criminal record check?
*
No
Yes
Types Of Volunteering
*
Please tick all that you would be available to assist with
Locations Available
*
Please tick all the locations that you would be available to volunteer at
Reference One
*
INCLUDE: FULL NAME - RELATIONSHIP TO YOU - ADDRESS - EMAIL - PHONE
Reference Two
*
INCLUDE: FULL NAME - RELATIONSHIP TO YOU - ADDRESS - EMAIL - PHONE
Declaration
*
I declare that the information contained in this application form is true and complete. I understand that if subsequently
discovered that any statement is false or misleading FACT will discontinue my volunteering role.
I understand that FACT will use and keep information I have provided on this application or elsewhere as part of the
recruitment process and/or personal information supplied by third parties such as referees, relating to my application.
I understand that the information provided will be used to make a decision regarding my suitability for volunteering
and if successful the information will be used to form my volunteer record and will be retained for the period set out
in FACT’s Data Retention Schedule.
Volunteer Confidentiality Agreement
*
While volunteering with FACT you may be required to collect personal information or to have access to personal
information on users, staff, volunteers and their families. This information must be kept confidential at all times,
including after you have left FACT.
It is the responsibility of all FACT volunteers to maintain the confidentiality and privacy of all users, staff, volunteers
and charity information to which they have access. This includes ensuring the security of documents, computer data,
photographs, financial and charity information relating to FACT, their donors and people supported by the charity.
It is hereby agreed:
1. While volunteering with FACT and after you leave, you will regard all information you have access to as
confidential unless advised otherwise.
2. You will not disclose information given to you to any third party (except another charity member authorised
to have this information) without prior consent.
3. You will keep user identity confidential, including names and addresses. The exception to this is where you
are subject to law to declare it. (For example, where there is evidence of a serious crime, act of terrorism, or
offences against children.) See safeguarding policy.
