Date of Birth:
Telephone No (day):
Telephone No (evening):
Relevant skills / experience / interests:
Have you any major health problems?
Do you have a full driving license?
Do you have a car?
Have you any endorsements?
(If yes please give details):
Make of vehicle:
(Please state 2 or 4 door):
2 Door4 Door
Please give the names and addresses of two people (not relations) who could comment on your suitability to work with vulnerable adults
Referee Number 1
Address and Postcode:
How does he / she know you?
How long has he / she known you?
Referee Number 2
How did you hear about the need for volunteers for this scheme?
We support our volunteers by providing Development Opportunities and Information. Is there anything you particularly feel you need to know to enable you to become an effective 'Friendly Neighbours' volunteer?
I give my permission for a Disclosure Search and agree to treat any information given to me in relation to my voluntary work with 'Friendly Neighbours' as strictly confidential.
I Agree to the Disclosure Search
If you need any help or advice applying for Attendance Allowance or a Blue Badge, please conta...
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67 New Park Street. Castlefields, Shrewsbury, SY1 2LE
T: 01743 235505 E: firstname.lastname@example.org