How did you find out about volunteering opportunities at the Peace Hospice Care?*
Peace Hospice Care Website
Recommended by a friend
SECTION 1 – YOUR DETAILS
Date of Birth
Contact Number (Home)
Contact Number (Work)
Contact Number (Mobile)
May we contact you at work?*
SECTION 2 – HOW CAN YOU HELP US?
Your volunteeing and work experience
Please tell us about your volunteering and work experience
Work / Volunteering Experience*
Not currently looking for work
Unemployed and looking for work
Please tell us a little bit more about yourself
For example your talents, interests other languages spoken*
We would like to offer you a volunteering role which is appropriate to your own emotional health and well being.
Have you had a bereavement of a close family member or friend in the last 2 years?*
If yes please give brief details
SECTION 3 – YOUR VOLUNTEERING OPTIONS
There are lots of ways to get involved. Please tick the roles where you would like to help.
Working with our patients and their families
Hospice at Home
Wellbeing / Creative therapy
Fundraising / Events / Retail
Corporate fundraising support
Practical support at events
Working with a charity shop
Driving (furniture and stock)
Charity tin distributors
House-keeping / laundry
Marketing & Communication
Other, please state
Your availability: Please let us know when you are normally available
SECTION 4 – REFERENCES
Please provide details below of two people who have agreed to supply a reference for you. They should not
be related to you, but should have known you for the last 2 years, and be able to comment on your ability to
fulfil the role you’ve applied for. Please complete all the boxes.
Name of organisaton (if appropriate)
How long have you known this person?
Name of organisaton (if appropriate)*
How long have you known this person?
SECTION 5 – PERSONAL DECLARATIONS
We welcome and value our volunteers for the skills they bring. To allow us to consider any appropriate adjustments to the volunteer environment and better support you in your role, please give details below of any relevant health issues (e.g. back problems)
During the course of your time with Peace Hospice Care you may have access to confidential information.
As a volunteer it is essential to respect the confidences of patients, visitors, staff and other volunteers. Volunteers must not, under any circumstances, disclose patient information or details to anyone outside the Hospice. Volunteers are expected to respect business and financial confidentiality.
Information cascaded within the Hospice is not for the public. The Hospice regards any breach of confidentiality very seriously. Any breach could result in the end of your volunteering at the Hospice. Criminal convictions
Many aspects of voluntary work at the Hospice mean that, under the Rehabilitation of Offenders Act (1974), you must declare all criminal convictions, however long ago these occurred. A conviction does not necessarily bar you from volunteering for us, but we do need to
Have you been convicted of a criminal offence?
Have you ever received a formal police caution?
Are there matters pending, which may result in a criminal conviction?
If you have answered YES to any of the above questions, please give details:
Eligibility to volunteer in the UK
If you are legally allowed to work in the UK on a permanent basis, you are also normally allowed to volunteer. However, people from outside the European Economic Area may need permission to undertake voluntary work. If in doubt, please contact us.
Are you legally eligible for a volunteering role in the UK?
No Applicant’s declaration
I confirm that the information I have given is accurate and that I have not knowingly withheld any information which is relevant to this application. I have read and understand the statement of Confidentiality and I understand that failure to comply could result in dismissal from my voluntary role. I consent to my information being held and processed by Peace Hospice Care or its agents in accordance with the 1998 Data Protection Act.
From time to time Peace Hospice Care would like to send you information about our work.
If you would prefer us not to use your details in this way, please tick here
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When you are happy with your application click send