VOLUNTEER REGISTRATION FORM

BONAGRASS GROVE LADIES HOCKEY CLUB

Name:____________________________________________________________________________

Address:  __________________________________________________________________________

__________________________________       Postcode:   __________________

Tel No:____ Home: _______________________  Work:  _____________________________

Email:_____________________________________________________________________________

Have you volunteered for a sports club / organisation before?       YES               NO

If yes, give details: __________________________________________________________________

What days and times are you available to volunteer? (Tick all that apply)

Are you currently

Employed             Unemployed             Student              Self-Employed              Retired

Other __________________________________________________________________

Are you volunteering as part of a student placement?                              YES            NO

If yes, have you had an enhanced disclosure check?

When ____________________     Who ____________________     Number _____________

Do you have public liability insurance through your college/University? YES         NO

State any relevant qualifications or experience:

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

DRIVING LICENCE

Do you have a full current valid driving licence?                          YES                        NO

Do you have access to a car?                                                         YES                        NO

Do you have any penalty points?                                           YES                        NO

If yes, give details ___________________________________________________________

REFEREES

Please provide us with the names of 2 people we can contact in respect of your application.  If you have worked, one must be your present or most recent employer and one must be related to working with children and young people under 18.

Name:            _______________________        Name:              ________________________

Address:       _______________________        Address:           ________________________

                       _______________________                                 ________________________

Tel No:           _______________________        Tel No:             ________________________

Occupation:    _______________________        Occupation:     ________________________

Relationship                                                    Relationship    

to Applicant:   _______________________        to Applicant:     ________________________

Please tick the relevant box(es) below if you do not wish your referees to be contacted without your consent.  It is our normal practice to request references prior to interview.

Referee 1                                                                 Referee 2

Do you consider yourself to have a disability?                       YES                       NO

If yes, give any information which may be relevant to volunteering in this type of work.

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

DECLARATION

I declare that the information given on this application is true and understand that canvassing of any employee or member of the club / organisation, directly or indirectly, in connection with this application shall disqualify me.  If you are invited for interview you will be asked to sign the application at this time.

Signed  _____________________________________        Date  ______________________