Personal Details

Please enter N/A if you do not have one or do not wish to provide this information.

Please enter N/A if you do not have one or do not wish to provide this information.

Please ensure you have filled out the relevant field above for your chosen option

Please state your usual availability.

Communication and access needs

Please tell us if you have any communication or access needs, so that we can enable you to participate. This could include information in large print, wheelchair access for meetings, a hearing loop or any other adjustment:


Please provide two references from people who have known you for at least three years.

Please ensure that these people have agreed to their contact details being shared.

Referee 1

Referee 2


By completing and returning this form, you are agreeing to have your details stored for this period of time. You are welcome to contact the team and terminate your application or information held at any time.

Equality Monitoring Information

The information collected will only be used for monitoring purposes in an anonymised format and will help the Trust analyse the profile and make up our volunteers to support our equal opportunities policy.

We recognise and actively promote the benefits of a diverse range of volunteers and are committed to treating all volunteers with dignity and respect regardless of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and sexual orientation.

Ethnic Origin

I would describe my ethnic origin as:


Please state the type of disability / impairment which applies to you. People may experience more than one type of impairment, in which case you may indicate more than one. If none of the categories apply, please mark ‘other’.

Sexual Orientation