Volunteer Form – Alliance Community Health CIC

Alliance Community Health CIC

+44 7425 199446
info.alliancecommunityhealthcic.org
Dorset, United Kingdom

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Volunteer Application

Section 1

Personal Details

First Name

Last Name

Date of Birth

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Contact No

Section 2

Emergency Contact

First Name

Relationship

Phone Number

Section 3

Availability

Days Available

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Hours per week available

Preferred times

Morning

Afternoon

Evening

Section 4

Volunteer Role Interest

Select Area of Interest

Section 5

Skills & Experience

Relevant experience (work or voluntary)

Skills (e.g. communication, admin, healthcare exposure)

Why do you want to volunteer with us?

Section 6

Safeguarding & Suitability

Have you worked with vulnerable adults before? (Yes/No)

Do you have any relevant training? (details)

Do you have a DBS check? (Yes/No/In progress)

Section 7

Health & Support Needs

Do you have any health conditions or support needs we should be aware of? (optional)

Section 8

References

First Name

Last Name

Relationship

Contact details

Section 9

Declarations

Confidentiality Agreement

I understand that I may have access to sensitive information and agree to keep all information confidential.

Safeguarding Commitment

I agree to follow safeguarding procedures and report concerns appropriately.

Data Consent

I consent to my data being processed in line with UK GDPR and Data Protection Act 2018.

Building Healthier Communities Through Care, Support and Connection

Contact Us

+44 7425 199446
info.alliancecommunityhealthcic.org
Alliance Community Health CIC
Company Number: 17154355

Registered in England and Wales
Registered Address: Lytchett House, 13 Freeland Park, Wareham Road, Poole, Dorset, BH16 6FA

Data security and compliance

SAFEGUARDING POLICY
DATA PROTECTION & PRIVACY POLICY (GDPR)
COMPLAINTS PROCEDURE
RISK MANAGEMENT POLICY
VOLUNTEER POLICY
HEALTH & SAFETY POLICY