Voluntary Work in Bexley Libraries

Personal Details

Surname:

Title:

-------- Mr Mrs Miss Ms Dr Rev Other

Forename(s):

Gender:

Male Female

Address:

Postcode:

County:

Telephone number:

Email address:

Driver's licence holder:

Yes No

Date of birth:

First language spoken:

Other language spoken:

Employment Status

Not currently seeking employment

Retired from employment

Unemployed but seeking employment

In full/part time employment

In secondary/higher education

New Deal/Millennium volunteer

Involved in training scheme

Retired but seeking employment

Ethnic origin details

Bangladeshi

Chinese

Pakistani

Black African

Indian

White

Black Caribbean

Irish

Mixed

Black Other

Other Asian

Other

London Borough of Bexley is committed to Equal Opportunities. Accordingly, the service wishes to monitor all relevant details, including origin, of all applicants for membership. Completion of this section is optional.

Emergency Contact Details

Name:

Relationship:

Address:

Postcode:

Telephone number - Day:

Telephone number - Home:

What experience and skills do you bring to bexley library service

Please check boxes and add further details if you wish:

Caring for others

Organisation

First Aid

Administration

Retailing

Health & Safety

Fundraising

Finance

Catering

IT

Training

Other

Driving

Public Relations

Further details:

Please give details of any other organisations for whom you have volunteered, with your experiences and dates involved:

Voluntary organisation:

Dates:

Position and responsibilities:

Voluntary organisation:

Dates:

Position and responsibilities:

Health

A disability or health problem does not exclude you from volunteering with Bexley Library Service. Applications from people with disabilities are welcomed.

Have you ever suffered, or do you suffer from any disability, or serious or contagious illness, that could affect your volunteering with Bexley Library Service.

Yes No

If yes, please give details.

It is important that you inform Bexley Library Service if you should suffer from any illness in the future that may affect your ability to volunteer for the service or that would put others at risk.

Would you describe yourself as having a disability?

Yes No

Criminal Offences

Because volunteering with Bexley Library Service may involve you in providing help and support to those in need in the community, including young children, the elderly and vulnerable people, we ask you to give details of criminal offences. A prior criminal conviction may not prevent you from working with the Service, but failure to disclose relevant convictions in full, will result in immediate suspension of membership pending investigation.

Have you ever received a criminal conviction?

Yes No

If yes, Bexley Library Service will need to assess whether this will affect the volunteering opportunity that we can offer you. All information will be kept confidential and the Rehabilitation of Offenders Act (1974) applies. Please give details below.

How did you hear about volunteering opportunities with Bexley Library Service?

(Please check all relevant boxes)

Knowledge of project

Volunteer Centre Bexley

Newspaper advertisement

Friend

Other: (Please specify)

References

Please provide two referees. One should be in a professional capacity, for example from a previous employer, doctor or minister. The referees should not be directly related to you and should have known you for at least one year. (Referees should not be directly related to you.)

Name:

Address:

Postcode:

County:

Telephone no:

Name:

Address:

Postcode:

County:

Telephone no:

I am willing to abide by the rules and uphold the ethos of Bexley Library Service.
I understand that my work may involve issues and situations of a sensitive nature and I agree to maintain confidentiality at all times.

Name:

Date:

All information will be held in a confidential manner and used for statistical purposes only.