Application Form
Food Bank Volunteer
www.sufra-nwlondon.org.uk
Registered Charity No. 1151911
Personal Details
First Name:
Surname:
Address:
Postcode:
Date of Birth:
Gender:
Telephone Number:
E-mail Address:
Ethnicity
White British
Asian – Bangladeshi
White Irish
Other Asian Background*
White Other
Chinese
Black Caribbean or British Caribbean
Mixed – White and Black Caribbean
Black African or British African
Mixed – White and Black African
Other Black background*
Mixed – White and Asian
Asian – Indian
Other Mixed Background*
Asian – Pakistani
Other Ethnic Background*
* If other, please indicate
Faith
Christianity
Buddhism
Judaism
Hinduism
Islam
Sikhism
No Religion
Other:
Disability
Do you consider yourself to be disabled? Yes
No
In order to make any reasonable adjustments which may be necessary, it will help us if you
indicate your specific needs.
Languages
Do you speak any of the following languages?
Arabic
Polish
French
Somali
Gujarati
Spanish
Pashtun
Tamil
Portuguese
Urdu
Other:
Why do you want to volunteer for Sufra?
Availability
Wednesdays (11:00am to 4:00pm)
Sundays (11:00am to 4:00pm)
How did you hear about us?
Our Mailing List
Volunteer Bureau
Other Mailing List
Referred by a Friend
Web Search
Referred by an Organisation
Other:
Criminal Convictions
Sufra – NW London operates a strict a strict policy to safeguard children, young people and
vulnerable adults who access our services. All successful applicants are required to undergo
an Enhanced DBS (formerly CRB) Disclosure.
Do you have any criminal convictions or cautions? Yes
No
If yes, please give details of the conviction(s) and date(s). Please note that possessing a
criminal record does not disqualify your application.
Referees
Please include details of TWO Referees.
Name:
Name:
Address:
Address:
Postcode:
Postcode:
Telephone:
Telephone:
Email:
Email:
Declaration
I agree to abide by Sufra – NW London’s Code of Conduct
I agree to attend any training/inductions sessions required for this role
I agree to commit to the minimum volunteer hours/period required for this role
Signature:
Date:
Sufra – NW London, 160 Pitfield Way, Stonebridge, London, NW10 0PW
Tel: 020 3441 1335 · Email: [email protected] · Web: www.sufra-nwlondon.org.uk
OFFICIAL USE ONLY
Confirmation of Receipt:
DBS Check:
Interview Date:
References: