Application form | Age UK East London

Where did you hear about Age UK East London?

Your details

Name *

Address *

Post code *

Home Tel No *

Mobile No *

Email *

In what capacity would you like to help as a volunteer with Age UK East London? Have you looked at the opportunities available on our website? *

Please tell us some more about yourself *

What skills and personal attributes could you bring to your role? *

What skills would you like to develop in your role? *

Do you speak any other language? *

Which of these best describes you current situation ( please tick one only) Employed Full-time Employed Part-time Long -term sick/disabled Carer Unemployed Student Retired

What days & time of the week are you available? *

References

Please provide details of two Referees (they must not be relatives or reside at the same address as you)

Referee 1

Name *

Address *

Post code *

Tel No *

Email *

In what capacity do you know the above referee? *

Referee 2

Name *

Address *

Post Code *

Tel No *

Email *

In what capacity do you know the above referee? *

Emergency Contact

Name *

Tel No *

Relationship to you *

Equality and diversity Form

Age UK East London wants to meet the aims and commitments regarding equality and diversity for our volunteers. This includes not discriminating under the Equality Act 2010, and building an accurate picture of the make-up of the volunteers in encouraging equality and diversity. The organisation needs your help and co-operation to enable it to do this:

Date of birth *

Gender Male Female Prefer not to say Other

Other gender *

What is your Sexual Orientation? Heterosexual Gay Lesbian Bisexual Prefer not to say Prefer to use my own term

If you prefer to use your own term, please specify here *

What is your Ethnicity? White British White British White Gypsy or Irish Traveller Any other white background White and Black Caribbean White and Black African White and Asian Asian or Asian British: Bangladeshi Asian or Asian British: Pakistani Asian or Asian British: Indian Any other Asian background Black or Black British: African Black or Black British: Somali Black or Black British: Caribbean Black/Black British/ Other Black Background Prefer not to say

Marriage and Civil Partnership? Single Married/in a registered same-sex civil partnership Separated, but still legally married/in a registered same-sex civil partnership Divorced/formerly in a same-sex civil partnership which is now legally dissolved Widowed/Surviving partner from a same-sex civil partnership Prefer not to say

What is your Religion or Belief? No religion or belief Buddhist Christian Hindu Jewish Muslim Sikh Prefer not to say Other

If other religion or belief, please write here *

Do you have Caring responsibilities? Yes No Prefer not to say

Do you consider yourself to be disabled? Yes No Prefer not to say

If disability, please specify *

Pregnancy & Maternity/Paternity Pregnant Had a baby in the last 26 weeks Currently Breastfeeding On maternity leave On paternity leave On adoption leave Not applicable Prefer not to say

Consent form

In order for us to work with you, we need to record your personal details and information about the service(s) you are volunteering in. To comply with the Data Protection Act (1998) we must tell you how we use this data and ask for your permission. By ticking the boxes and signing this form you are providing your permission for us to process your data for the purposes below.

I give consent for Age UK East London to record and use my personal information and details to help with my volunteer role(s). I understand my record will be kept for 6 years only after the last recorded intervention Yes No

I give consent for Age UK East London to contact my referee’s via email or letter Yes No

I give consent for Age UK East London to contact me for feedback re my volunteering Yes No

I give consent for Age UK East London to share anonymised information about me and my volunteering with funders & in training to help show the impact of the service and help ensure it continues Yes No

There are some Age UK East London projects that need to submit monitoring information to the Lead Partner Organisation/ funder(s). On these occasions we will forward your details to the organisation who will store this information on a secure internal recording mechanism.

Samples of Age UK East London’s case files are checked by external auditors to check the quality of our service. They have a professional duty to keep all information confidential. We will only let them see files where we have consent to do so.

I consent to external assessors looking at my case file Yes No

Multiple or single I consent to being contacted by the following methods (please tick those you are happy with) choice Telephone Email󠆺 Letter Text Other

If other, please specify *

Useful information about privacy and consent

What is personal and sensitive data? Personal data is data which can be used to identify you. This may include your name, date of birth, address, telephone number etc. Sensitive data is information related to any of the following: racial or ethnic origin, political opinions, religious beliefs, trade union membership, health, sexuality or sex life, offences and/or convictions. The kind of information we record and use It is up to you to decide what you share with us. Some information is personal, it could be used to identify you. This includes your name, date of birth, address, or phone number. Some may be sensitive information related to your racial or ethnic origin, political opinions, religious beliefs, trade union membership, health, sexuality or sex life, offences or convictions. How we’ll store your information We’ll store the record of your case in a secure case management system, which is only accessed by the Age UK East London staff and volunteers. How we might share your personal information We won’t share your personal information without your permission, unless we’re required to do so by law, for example in safeguarding situations. We will share anonymised (unnamed) information about you, how you contacted us, what type of volunteer role you are doing and the impact of your help to Age UK East London with our funders. How long will you keep my information? We will keep a copy of your information on our computer, database or paper files for 6 years after our last contact with you. If we do not hear from you for 6 years we will remove your information and destroy any paper records we are holding. Complaints handling procedure If you're unhappy with how we record and use your information please contact us at info@ageukeastlondon.org.uk or leave your comments through the feedback page.

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