Action Packed Holidays that Embrace Every Ability
VOLUNTEER APPLICATION FORM
Private and Confidential
Please write clearly in BLOCK CAPITALS USING BLACK INK
Name …………………………………………………………………Date of Birth ………………………..………………….. Sex M/F
Address
……………………………………………………………………………………............……………………………………………………
………………………………………………………………………………………… Post Code ………………………………………
Telephone number ………………………………………Mobile number………….........……..…………………………………………….
Email address....……………………………………………………….............……………………………….
Which Camp are you applying for? Please note in order to give everyone ample opportunity to submit their form, we will
wait until 27th February 2016 before processing the first round of applications. Applications received after 27th February
2016 will still be considered for all remaining places.
NOTE: we will process applications for the Easter camps for adults straight away and seek to let you know much sooner.
1st Choice ……………………………………………………… Dates……………………………………………………………………..
2nd Choice …………………………………….………............ Dates ……………………………………………………………………
Do you have any form of disability that may mean you are unable to participate fully as a volunteer? Yes/No
If yes please give details (this will not prevent you from being considered for a place
…………………………………………………………………………………………………............…………………………………………
............................................................................................................................................................................................................
Do you hold a full driving licence?
Yes/No
Would you be willing to drive a minibus on your Camp?
Yes/No
What year did you pass your test? ……………………… Do you have a category D1 marked on your licence? Yes/No
Do you have any driving convictions or points?
Yes/No
Minibus driving experience (include any qualifications especially MIDAS or if you have D1 on your licence) .................................
Have you volunteered on a Birmingham PHAB Camp before? Yes/No
Have you ever completed Safeguarding Training Yes/No? If Yes please state date and training body ….............…………………
……………………………………………………………………………………………………………….............…………………………
Would you be willing to complete Birmingham PHAB Camps’ Safeguarding Training Course (online course) Yes/No?
What is your occupation?
……………………………………………………………………………………………………………............……………………………
How did you find out about Birmingham PHAB Camps?
……………………………………………….............…………………………………………………..…………
Birmingham PHAB Camps receives no government funding and relies entirely on its supporters to raise enough money to run
our holidays. Information about our ongoing fundraising events and activities are shared through our Friends of PHAB emails. If
you would rather not receive these emails please tick here (or type an X next to)
Registered Charity Number 502073
1
Please find attached our Volunteer Role Description. In around 300 words please tell us a little about why you are applying to
volunteer and what you think you will bring to camp. If preferred, this section can be typed and attached.
Registered Charity Number 502073
2
Please give details of two people, one if you have volunteered on a Camp before, who are not related to you or involved with
Birmingham PHAB Camps, who are prepared to act as referees for you. They should know different aspects of your life, and,
if possible, in a professional capacity.
First Referee
Name ……………………………………………......... Job Title (if relevant to reference): ........................................................
Telephone Number. .....…………….......................... Email Address: .......................................................................................
Address………………………………………………………………………………………............………………………………………
…………………………………………………………………………………… Post Code ………………………………………………
In what capacity does referee know you? ……………………………………………………………………………………….
How long has referee known you? ………………………………………………………………………………………………………..
Second Referee, (not applicable if you have volunteered on a previous camp with Birmingham PHAB Camps).
Name ……………………………………………......... Job Title (if relevant to reference): ........................................................
Telephone Number. .....…………….......................... Email Address: .......................................................................................
Address………………………………………………………………………………………............………………………………………
…………………………………………………………………………………… Post Code ……………………………………………
In what capacity does referee know you? ………………………………………………………………………………………………….
How long has referee known you? .....………………………………………………………………………………………………………..
Do you, or have you ever had, any criminal or civil convictions?
Yes/No
Are you awaiting trial?
Yes/No
Volunteering with Birmingham PHAB Camps will involve close contact with children on a daily basis. Is there any reason why
anyone may question your reliability?
Yes/No
If your answer to any of the above questions is 'yes' please give details on a separate sheet
Have you ever given permission for a Disclosure and Baring Service (formally CRB) check to be completed?
Yes/No
If so, for whom was this done and when? ……............…………………………………………………………………..…
For the purpose of our equal opportunities monitoring please indicate what you consider to be your ethnic origin?
……………………………………………….………………………………………………………………………………………………
DECLARATION:
By submitting this form, I, (print full name) ………........……………………………hereby certify that the information included is
complete and accurate. I authorise Birmingham PHAB Camps to make all necessary enquiries to verify this information
including, but not limited to, requesting Disclosure and Baring Service (formally CRB) check.
Postal submissions please sign below, if submitting by email please type your name in the space provided.
Signature ……………………………………………………….. Date ……………………………………………………………….
Please return this completed application form by email (preferable) to:
[email protected]
Or by post to:
Volunteer Recruitment Team, 333 Redditch Road, Kings Norton, Birmingham, B38 8PP
We will send you acknowledgment on receipt of application.
NB: to be considered for the first round of applications for 2016, please return this 27th February. If you are applying
after this date, your application will still be considered for all remaining places. NB: For the Adult Camps at Easter, we will
process applications straight away, and let you know much sooner.
Confirmation of your acceptance on the holiday, subject to a Disclosure and Baring Service (formally CRB) check and
satisfactory references, will be sent during March or within one month of your application thereafter, at which point your security
deposit of £25 is required.
If you have any queries then please contact a member of the Volunteer Recruitment Team.
Registered Charity Number 502073
3