Home-Start Greenwich
Volunteer Impact Management System (VIMS)
Monitoring Form
Home-Start Greenwich is committed to safe recruitment practice as an important part
of safeguarding and protecting children and vulnerable adults
The information you give in this form will not be used for volunteer selection purposes. It helps
us to get an overall picture of our volunteer team in comparison with the families we support
and the communities we live in. Although this section is optional, we would really appreciate
your participation as it can often assist in funding bids and awareness raising.
Age Range:
16-24
25-34
35-44
45-54
55-64
Over 65
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Gender
Sexual Orientation
Heterosexual
Male
Lesbian
Female
Gay
Transgender
No Response given
Bi-sexual
Disability
No Response given
Do you consider yourself to
have a disability? Y/N
Housing (please tick all that apply)
Privately Owned
Temporary Housing (e.g. B&B,
Refuge)
No Response given
Please specify
Privately Rented
Other (please specify)
Social Housing
Immigration Status
Are you a British
Citizen/national of European
Economic area? Y/N
Do you have the right of
residence in the UK?
Y/N
Are you an asylum seeker?
Y/N
Asian or Asian British
Black or Black British
White
Indian
Caribbean
British
Pakistani
African
Irish
Any other Asian background
Please specify
Any other Black
background
Please specify
Any other white background
Please specify
Chinese or other ethnic group
Mixed
Chinese
Any mixed background
Other
No Response given
Immigration Status
Are you a British
Citizen/national of European
Economic area? Y/N
Do you have the right of
residence in the UK?
Y/N
Bangladeshi
Please specify
Are you an asylum seeker?
Y/N
No Response given
Religious Beliefs
No Response given
Please specify
2
How did you hear of Home-Start? (please tick all that apply)
a)
Internet
b)
Newspaper advert
c)
Local radio
d)
Word of mouth: e.g. another volunteer, a friend
e)
Leaflet through letterbox
f)
A story in a paper/magazine
g)
Received support as a Home-Start family
h)
Local voluntary organisation
i)
Home-Start newsletter
j)
Previous Home-Start experience
k)
Other, please specify ..............................................................
For Office Use:
ID:
Date rcd:
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