Sandwell Visually Impaired Volunteer Application Form

Name *

Your title *

Your address and postcode *

Date of birth *

Contact number *

Are you a visually impaired or disabled person? *

Do you have any access requirements that you feel we should be aware of at this stage? *

Why would you like to volunteer with SVI? *

What type of volunteering with SVI are you particularly interested in? *

What relevant experience do you have? *

Qualifications and training *

Reference 1 *

Please give details of two people whom we may contact for a reference. References should be provided by people whom you have been in contact with over the last two years. Preferably they should be people who have known you in a professional capacity (for example an employer, course tutor, volunteer co-ordinator) and can comment on your suitability for the position of a volunteer with SVI. Personal references (i.e. from your GP or friends) are not suitable. If you would like further guidance on who to put as a referee, please contact the SVI office.

Reference 2 *

Some voluntary positions within SVI require a DBS check (formerly CRB). In the meantime, we would be grateful if you could answer the following questions (disclosure of a criminal record will not automatically exclude you from volunteering.) Do you have any criminal convictions, bind-overs, orders or cautions? *

If yes, please give details. *

Declaration *

By submitting this form, I confirm that the information I have given is correct and complete to the best of my knowledge and that any misleading or untruthful statement made could result in me being disqualified from volunteering.

Confirm your name *

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Sandwell Visually Impaired Volunteer Application Form

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