Returning volunteer application form

Revive Returning Volunteer Application Form 2015
Team Leaders: This form is ONLY suitable for volunteers who volunteered at
Revive 2013 or Revive 2014, and who you have had regular contact with over the
past year, and know very well. If you have any concerns about a team member,
Attach photo here
or their suitability since last year they should fill in a full application form. This
Alternatively you can
information is confidential to the Revive team.
email a photo to
revive@ichthus.org.uk
Personal Details
Title:
Name:
Surname:
…..
Address
………
If you emailed one last
year we will still have it so
no need to send us one
………
Telephone:
Gender:
Postcode
……….
Mobile:
……………………………………
Date of birth:
Email Address:
…………
Dependents on site with you:
….
….
Please give names and dates of births
Team (See volunteer information leaflet for more details)
Teams for which you want to apply:
First choice:
Second choice
Church leader reference
Name:
Email:
Phone:
Further Information
Have you had any changes in your health since last year that may affect your ability to work?
….
….
……..
Have you experienced any nervous, mental or emotional health problems since last year?
….
….
….
Do you have any police enquiries or case of prosecution pending? Have you been charged with any criminal
offence since you applied in 2013 or 2014? If yes, please tick
If you have ticked, a senior leader in Ichthus will contact you in strict confidence to discuss this.
Under the Rehabilitation of Offenders Act 1974, you are not required to disclose any conviction that has become
spent, unless you intend to work with children.
Volunteer Meals
For volunteers and immediate family (i.e. husband, wife or children) only. The first adult will receive a subsidised
rate of £100, and teenagers (13-17) will receive a subsidised rate of £100. Otherwise the cost of adult food for the
full week is £120. This includes a sit-down breakfast and dinner. Lunch will be provided in the food court.
Volunteers: …. Family (adults, 18+):
£0 each
Family (13-17)…….. Family (5–12yrs):
£120 each
Total requiring volunteers meals:
£100 each
Family (0-4yrs):
£50 each
Total volunteers meal cost:
(If unsure leave blank and we will do the calculation for you)
Please turn over for important declaration and signature
Free
Declaration
‘I wish to apply to volunteer at Revive 2015 and confirm that I have read and fully understand the duties of the team I have applied for. I hereby
declare that the information I have given is to the best of my knowledge current, true and accurate, and that I am fit and able to fulfill the duties
for the team for which I am applying. I am happy for Ichthus Christian Fellowship to obtain references from the people I have named above. I
declare that I have no criminal convictions that would affect my suitability to work with children. I give Ichthus permission to request a DBS
check.’ Ichthus will request a DBS Enhanced Disclosure for all volunteers applying to work with children, or young adults.
As a trust, we undertake to meet the requirements of the Data Protection Act 1998, the Protection of Children Act 1999, the Criminal Justice and
Court Services Act 2000 and all other relevant legislation.
Signed:
………
Date:
! Your details are stored on a database for administration purposes. We may send you
information, by email or other means, of other activities organised by Ichthus Christian
Fellowship. Tick here if you do not wish to receive this information.
…….
Return to:
Revive Volunteers
Ichthus Christian Fellowship
7 Greenwich Quay
Clarence Road
LONDON
SE8 3EY