Volunteer application form

Title *

First name *

Last name *

Email *

Phone *

Address details

Address

Address:*

Enter address manually

As a volunteer, we’ll send you our biannual volunteer magazine, Volunteer Voice. What is your preferred format? *

Large print (English) Large print (Welsh) Audio CD Read/listen online

We send mail marked with ‘Articles for the Blind’ on the envelope. This is a Royal Mail postal scheme which allows certain items to be sent to blind and visually impaired people for free. *

Yes please use this service Do not send my mail via this service

Rehabilitation of Offenders Act 1974:

Your role may bring you into contact with vulnerable people, so you are required to declare all convictions. Depending on the role, you may also be subject to a check by the Disclosure and Barring Service.

Do you have any unspent convictions? *

No Yes

Please give further details

Volunteer references

We need to take up two references for all our volunteers. Please give the names and contact details for two people (not related to you) who know you well (for at least six months) and would be happy to answer a few questions about you. We will only use their details for this purpose.

Referee 1

Referee 1: Full name *

Referee 1: Address

Address:*

Enter address manually

Referee 1: Email address *

Referee 1: Relationship to you *

Referee 2

Referee 2: Full name *

Referee 2: Address

Address:*

Enter address manually

Referee 2: Email address *

Referee 2: Relationship to you *

Declaration

I confirm that to the best of my knowledge the information I have provided on this form is correct and I accept that providing deliberately false information could result in the termination of my role as a volunteer.

I confirm the above details are correct *