PERSONAL AND CONFIDENTIAL
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FORM 3
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Volunteer ID No.
Title
Male
Female
First Names
Date of Birth
Sp Check
PLEASE USE CAPITAL LETTERS
/
/
National Insurance
Surname
Number (If known)
Any Previous
Surnames
RSPB Member?
Membership No.
House Number
Telephone Numbers
House Name
Home
Street Name
Work
Yes
No
Preferred contact
Mobile
Town
Fax
County
How would you prefer to receive information?
Postcode
By e-mail
Country
Through the post
E-mail
Occupation
Please tick the boxes to indicate to us your availability
Monday
Tuesday
Saturday
Sunday
Wednesday
Please indicate the volunteering role(s) you are
interested in?
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Thursday
Friday
PERSONAL AND CONFIDENTIAL
Sp Check
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/
FORM 3
Volunteer ID No.
Emergency Contact Details
(Who should we contact if you are taken ill whilst
volunteering?)
Name
Relationship to you
Home Phone
Work Phone
Mobile Phone
To help WPYS ensure your safety:
Please note any relevant health details (allergies, asthma etc)
any mental or physical difficulties and the sort of
work/activities these might prevent you from doing.
To ensure First Aiders are aware of relevant information,
please also inform us of any medication you are taking.
Do you wish to pursue a career in conservation?
Yes
No
Do you have a full UK driving licence?
Yes
No
Do you have use of a car?
Yes
No
How did you hear about volunteering with
Wild Place, Your Space?
Family/Friends
Local newspaper
Volunteering information
at an event
Other – please indicate
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Website
Occasionally
I have the following experience of volunteering (this can be for any organisation):
Please add any other information you think might be helpful. Are there any particular volunteer activities you do not
want to do?
I have the following skills/experience I would like to offer the WPYS:
Referees
Please provide the names and addresses of two people who are not related to you or live in the same household that we
may contact for references.
Please Use Capital Letters
REFEREE 1
REFEREE 2
Title
First Names
Surname
Any previous surnames
Address
Postcode
Is this address
Home
E-mail
Day time telephone no.
Occupation
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or Business
Home
or Business
Criminal Offences
Please give details of any unspent criminal offences in accordance with the Rehabilitation of Offenders Act Order 1974 or
the Rehabilitation of Offenders (Northern Ireland) Order 1978. (Use and attach an additional sheet if necessary)
Any information given will be held in confidence. If you have any concerns about filling in this declaration please contact
the office on 0208 5250547or email [email protected]
Consent for Record Checks and Declaration of Suitability
I declare that I have disclosed all information requested. I understand that incomplete registrations will not be considered,
and that providing false information is grounds for immediate disqualification from the role, or even immediate removal
from the role if the falsehood is discovered after appointment.
I authorise the RSPB on behalf of WPYS to request references from the referees I have provided. I understand that any
information received about my background from referees, including details of any convictions, will be dealt with
confidentially and not used to discriminate against me unfairly.
During my volunteering I understand I may be working with material that is not public knowledge and I will ensure this
material remains confidential. Insurance for personal effects (e.g. optical equipment etc) is my responsibility.
I am happy to volunteer with the WPYS but understand that this agreement to volunteer is not intended to be a legally
binding contract between us and may be cancelled at any time at the discretion of either party. Neither of us intends
any employment relationship to be created either now or at any time in the future.
Signed
Date
The WPYS Office will retain your details for personnel administration, market research and analysis of your work as a
volunteer, including assessing your suitability for future volunteering or employment opportunities.
Wild Place, Your Space (WPYS) is a project created by the Royal Society for the Protection of Birds (RSPB) and the Lee
Valley Regional Park Authority (LVRPA) to bring people closer to nature.
The RSPB and LVRPA would like to send you information about conservation, campaigning, volunteering and fundraising
activities. The RSPB and LVRPA may review your details and use them for market research and analysis
If you would like to share your details with the RSPB and LVRPA once the WPYS project has finished please tick
this box
Thank you for taking the time to complete the form. Please return it to the address below.
Please print out and return this completed form to:
Wild Place, Your Space.
Volunteering
1a Connaught Close
Lea Bridge Road
Leyton
PageLondon
4 of 5
E10 7QS
RSPB OFFICE USE ONLY – PLEASE USE CAPITAL LETTERS
Volunteer’s Role Title:
Volunteer’s Line Manager:
Reserve/Location volunteer will be volunteering at:
Vacancy ID:
Start Date:
Young People & Vulnerable Adults Vetting Toolkit used to assess this role?
Yes
No 
If Yes Young People & Vulnerable Adults Vetting Toolkit score
Identity Checks - Form of Identity Provided:
Passport (any nationality)
UK Driving Licence
(either photo card or paper)
Original UK Birth Certificate
(Issued within 12 months of date of birth)
Valid photo identity card
(EU countries only)
Seen by (print name):
Date seen:
Do we need to archive this vacancy or reduce the number of volunteers required – MUST BE COMPLETED
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