Volunteer Profile Form

First Name
Surname
Address Line 1
Address Line 2
Address Line 3
Address Town
Address Postcode
Telephone
Mobile
E-mail
Date of Birth
Ethnicity Asian (Bangladeshi)Asian (Indian)Asian (Other)Asian (Pakistani)Black (African)Black (Caribbean)Black (Other)ChineseChinese (Other)Mixed (Other)Mixed (White & Asian)Mixed (White & Black African)Mixed (White & Black Caribbean)White (British)White (Irish)White (Other)
Gender MaleFemaleOther

Employers, pastors, friends, neighbours but not family relatives. Both referees need to be over 18 and have known you for a minimum of two years.
Referee Name
Referee Address Line 1
Referee Address Line 2
Referee Address Line 3
Referee Address Town
Referee Address Postcode
Referee Contact Telephone
Referee Mobile
Referee E-Mail Address
Their relationship to you
Years Known

Employers, pastors, friends, neighbours but not family relatives. Both referees need to be over 18 and have known you for a minimum of two years.
Referee Name
Referee Address Line 1
Referee Address Line 2
Referee Address Line 3
Referee Address Town
Referee Address Postcode
Referee Contact Telephone
Referee Mobile
Referee E-Mail Address
Their relationship to you
Years Known

I agree that while volunteering with GreenHouse Mentoring, prior to an enhanced level DBS for working with children being arranged, in whatever capacity, I will not allow myself to be left alone with another person under the age of 18 years. (I understand that an adult who has been DBS checked must always be present.)

Acceptance Criteria

GHM Reserves the right to reject applications from new or returning Staff or Volunteers if they are or have been deemed as unsuitable for GHM.

Data Protection

I give my consent to GreenHouse Mentoring holding personal data about me:

• I have been advised that GreenHouse Mentoring will hold this information securely and use it only for the purposes of GreenHouse Mentoring work.

• I understand this information will be kept confidential, and only disclosed, without my consent, in the event that GreenHouse Mentoring is required by law to do so.

• I understand that I have the right to see this information at any time.

I accept the above

Image Consent

Personal Data/Image - Under the terms of the Data Protection Act 1998, your consent must be obtained before GreenHouse Mentoring can use your personal data or image in our promotional material. You should be aware that this means that information about you could be made available worldwide including in countries where there is no data protection legislation.

I am happy for GHM to use photos of those mentioned above in the way described (If you do not select Yes in the box above then GHM will not use photographs under any circumstances.)
Yes

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If Other, please tell us the name of the organization:
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Are you fluent in any other language(s)? Please list them here.