Volunteer Application Form

Thank you for your interest in becoming a volunteer with The Nightingale. Simply put, we couldn’t achieve as much as we do without the outstanding support and work of our volunteers. Once you complete the Volunteer Application below we will be in touch shortly to discuss your application, the role/s you have applied for and an interview date.

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Date of birth(Required)

Which Volunteer role/s are you interested in?(Required)

Please tell us a bit about yourself(Required)

Taking into account the role description/s and personal qualities required for this position, tell us about your skills, experience and any previous employment which you think qualifies you for this role.

What is your availability?(Required)

Indicate the days and times that you would be available and whether you are available on a regular or occasional basis.

Do you have any medical issues?(Required)

Provide details of any medical condition/s that could affect your ability to undertake tasks, or anything that you feel could be relevant.

Do you hold any unspent criminal convictions or have any pending court cases?(Required)

Yes

Because of the nature of the support given by The Nightingale Cancer Support Centre, all staff (paid and voluntary) are required to provide details of any current convictions, or convictions for which for other purposes are 'spent' under the provisions of the 'Rehabilitation of Offenders Act 1974 (Exceptions) (Amendments) Order 1986'.

If yes, please provide details of the criminal offence(s) including dates and sentences

References

Please provide details of two people, not relatives, who may be approached for a reference. You must have known these people for a minimum of two years.

Name(Required)

First Last

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

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