Volunteer application form


If you're a parent or a carer, or maybe a grandparent, you know just how tough family life can be at times.

Our volunteers will usually visit a parent in their home once a week for a couple of hours. How they help is really down to the needs of the family. Some might need a sympathetic ear, a shoulder to cry on, someone to have a laugh with. Others may need help keeping appointments or accessing local services and 'connecting' with their local community. Our volunteers can provide an extra pair of hands to help people cope with everyday parenting situations, or practical help with activities like playing or reading stories. Home-Start's approach is very personal and friendly and this often reassures parents that what they're going through is not unusual, that they are not alone.

If you would like to become a Home-Start volunteer, please fill in and return the application form below.

Please provide the following contact information:

First Name
Last Name
Middle Initial
Title
Address
Address (cont.)
Town
County
Postal Code
Work/Mobile Phone
Home Phone
E-mail

If you have been at this address less than 2 years please give previous address:


Age and Sex:

Date of Birth
Sex Male Female

Place of birth


Ethnic origin - Choose one of the following options:

 

Languages spoken


Names and ages of your children


Please give information about your parenting experience


Please give the name and address of two referees (not relatives) who may be contacted by Home-Start:

Name
Title
Organisation
Address
Address (cont.)
Town
County
Postal Code
Work/Mobile Phone
Home Phone
E-mail

Please give the name and address of a second referee:

Name
Title
Organisation
Address
Address (cont.)
Town
County
Postal Code
Work/Mobile Phone
Home Phone
E-mail

Have you any commitments, which could affect your work with Home_start, eg part-time work or are you currently employed? If so for how many hours per week


What kind of work are you doing and what kind of work have you done in the past?


Please give details of any voluntary/paid work you have done, particularly with children and families:


Have you any skills or personal experience which may be relevant to your work as a Home-Start volunteer?


Do you hold a current clean driving licence?

Yes No

Do you have any medical condition that could affect your work as a volunteer?

Yes No

If yes, please describe


What are your hobbies/leisure interests?


How did you hear of Home-Start?

Why would you like to become a Home-Start volunteer?

Do you have any skills or personal experience, which may be relevant to your work as a volunteer for Home-Start?

Is there any other information you would like to add?


Do you agree to undergo a Criminal Records Bureau check?

Yes No


Home-Start Surrey Heath.
Copyright 2003 Home-Start Surrey Heath. All rights reserved.
Revised: 04/20/08