ࡱ> [ #bjbj ΐΐ'QQQQQ4hL9i/<" ///////0G3v/Q="==/QQ#/q q q =QQ /q = /q q @-|p.p`F|-.9/0i/-3q3$p.3Qp.q Rl//g i/====3 :  VOLUNTEER APPLICATION FORM - CONFIDENTIAL Please contact us if you need help to complete the form or would like it in a different format. Which role are you applying for? Advice ( Admin ( IT ( Social Policy ( Assisted information worker ( Nam 1. NAME Mr/Ms/Other (please state) FIRST NAME FAMILY NAME  2. ADDRESS TELEPHONE NUMBER (Landline & Mobile please!) EMAIL (Please check regularly!)  3. PLEASE TICK WHICH DAYS YOU CAN WORK. Advice volunteers should indicate at least 2 days per week Days 9.30am 5.00pm Monday ( Tuesday ( Wednesday ( Thursday ( Friday ( PLEASE TICK WHICH BUREAUX YOU CAN WORK AT Mare Street (Hackney) ( Whitechapel (Tower Hamlets) ( Dalston (Hackney) ( Adviceline (Newham) ( Custom House (Newham) ( Stratford (Newham) ( What do you think are some of the main problems facing the local community? Think about problems you and friends or relatives have encountered in the past, and things you have noticed about your local area. 6. Please tell us about any qualifications you have or training you have done which you feel is relevant to your role. 7. Why do you wish to join the CAB? 8. Please tell us about any relevant experiences that you have. For example employment, school placements, voluntary work, life and family experiences, work with community groups. 9. We would like you to state your skills and abilities that would be relevant to the role you are applying for. Please look carefully at the role description, and write full sentences in your own words. 10. Please tell us about any specific needs you would like us to take into account, either at the interview or if we offer you a volunteer role. For example mobility, childcare responsibilities, specific computer software needed, environments you can or cant work in, adjustments we can make. This information will be treated as strictly confidential and we will do our best to enable you to volunteer. 11. Volunteers wishing to train as advisers ONLY: Have you ever committed an offence under section 25 and 26 (1) (d) or (g) of the Immigration Act 1971? (These offences concern assisting illegal entry, falsifying documentation or obstructing the authorities investigating immigration offences. If you have committed one of the offences above you may still be able to be an adviser: however, we would have to contact the Office of Immigration Services Commissioner in order to discuss the issues.) Please tick as appropriate. YES / NO  12. REFERENCES: Please give the names and addresses of two people who are not related to you or part of your household, e.g. employer, college, university, someone who knows your skills/abilities. First Referee Second Referee Name Name Address Address Capacity in which they know you: Capacity in which they know you: I declare the information on this form is correct to the best of my knowledge. Signature ____________________ Date ______________ Please return this form to The Volunteer Coordinator, East End Citizens Advice Bureaux, 236-238 Mare Street, Hackney, London, E8 1HE EQUAL OPPORTUNITIES MONITORING INFORMATION The CAB Service aims to provide equal opportunities and fair treatment for all people applying to be bureau workers regardless of race, sex, disability or whether they are lesbians or gay men. The Service is also committed to ensuring that bureau workers reflect the community that they serve. In order to monitor the effectiveness of the Equal Opportunities Policies, we would be grateful if you could complete this form. We assure you that: ( The information provided will not form the basis of any recruitment and selection ( The information from the application form is confidential and will only be used for statistics ( Should you choose not to complete the questions below, this will not affect your application. Please indicate the appropriate answer Age: Date of Birth Gender: Female / Male Would you describe yourself as disabled? Yes / No If yes, are you registered disabled? Yes/No Please indicate your ethnic group by ticking one box: White ___ British ___ Irish ___ Other whiteMixed ___ White and Black Caribbean ___ White and Black African ___ White and Asian ___ Other Mixed Other ethnic group ___ Chinese ___ Turkish ___ Kurdish ___ Other Ethnic Group (Please say which)Asian or Asian British ___ Indian ___ Pakistani ___ Bangladeshi ___ Other AsianBlack or Black British ___ Black Caribbean ___ Black African (where?) ______________ ___ Other Black Are you currently Studying Part Time Studying Full time Working Full Time Working Part time Unemployed Retired Homemaker Carer Lone Parent Other(please state)___________ What prompted you to apply? Volunteer bureau (which one?) Using CAB yourselfJob Agency (Eg Job Centre, Reed) Please state which Friend or Relative recommendedInternet Site (state where) Poster (state where) Training organisation or programme eg. CDG, Community LinksAdvert (state where) Other (please specify) Thank you.     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