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Barnet
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Registration Form for Volunteers
Language
Undefined
Title
*
Mr
Mrs
Miss
Ms
Other
First Name
*
Surname
*
Address
Postcode
*
Telephone Number
(landline)
Mobile Number
*
Email
*
- Select -
I do have an Email Address (please provide below)
I do not have an Email Address
Email Address
How did you hear about Volunteer Centre Barnet?
*
Barnet and Southgate College
Barnet Council
Care/Support Worker
CommUNITY Barnet Website
Google
Job Centre
Middlesex University
NHS
Pro-Active North London
The Network
Work Clubs
Other
If Other, please specify
Age
*
Under 18
18 - 25
26 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
Over 65
(Please tick age range)
Employment
*
Employed
Non Employed
Retired
Self Employed
Student
Unable to work
Unemployed
(Please tick your employment status)
If unemployed, please specify for how long?
Do you regard yourself as having any disability?
*
Yes
No
If yes, please provide us with more details (optional)
Ethnic Background
*
Black African
Black Caribbean
Bangladeshi
Chinese
Indian
Other Asian Background
Other Black Background
Other Mixed Background
Other White Background
Pakistani
White British
White Irish
White Scottish
Other
Do not wish to disclose
(This is for monitoring purposes)
Availability
*
Saturday
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
(Please tick which days and times you are available for volunteering)
Other Availability Requirements
Long-term (minimum once a week for 6 months to a year)
Short-term (minimum once a week over 3-6 months)
School Holidays
School / College Term-time
Other
Please give brief details of any previous experience of voluntary and/or relevant paid work
*
What special skills do you have to offer?
Which languages do you speak other than English?
Do you have any special needs?
*
Yes
No
If yes, please give any other information below that will help us to help you.
Do you have a support worker who would be assisting you while you volunteer?
Yes
No
If yes, please provide us with their contact details
Areas of Interest
*
Animals
Art and Culture
Children -Under 5's
Children - 5-13
Disability (physical disability)
Disability (learning)
Disaster Relief
Domestic Violence
Drugs and Addictions
Education and Literacy
Elderly
Employment
Environment
Families
Gay, Lesbian, bi and Transsexual
Health, Hospital, Hospices
Heritage
Homeless and Housing
Human and Civil rights
International Aid
Legal Aid and Justice
Mental Health
Mentoring & befriending
Museums
Music
Politics
Prisoners & Ex-Offenders
Race, Ethnicity, Refugees
Religion
Sport & Outdoor Activities
Women's Groups
Youth (16 - 25)
(Please indicate areas you are interested in)
Type of Activity
*
Administration
Advice Work
Architecture and Building Work
Art / Craft
Befriending and Buddying
Business, Management
Campaigning and lobbying
Caring
Catering
Community work
Computers, Technology, Website Design
Counselling
Driving
Employee and Group Volunteering
Entertainment
Finance, Accounting
Fundraising
Gardening
General, Helping
Hostel work
Languages
Legal Work
Local Events
Marketing, PR and Media
Music
National & International Events
Practical work, DIY
Research
Retail and Charity Shops
Sports Development
Teaching, Training, Coaching
Trusteeship, Committee work
Youth Work
(Please indicate what you are interested in doing)
Reference Numbers
Please give the reference numbers to the opportunities that you are interested in.
Declaration
*
Yes
I declare that the above details are correct to the best of my knowledge. I understand these will be stored on the Volunteer Centre Barnet database and will be used for statistical purposes. I understand that the information will be forwarded to organisations where I wish to volunteer, only with my permission.
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Name of Organisation:
Barnet House
Address:
1255 High Rd London
Postcode:
N20 0EJ
Telephone Number:
020 8364 8400