Application form | Age UK East London

Where did you hear about Age UK East London?

Your details

Name*

Address*

Home Tel No

Mobile No*

Email

Please outline any interests, hobbies, previous experience

In what capacity would you like to help as a volunteer with Age UK East London? This could include something different to our normal volunteering opportunities

Do you speak any other language?

What days & time of the week are you available?

References

Please provide details of two Referees (they must not be relatives)

Referee 1

Name

Address

Tel No

Email

In what capacity do you know the above referee?

Referee 2

Name

Address

Tel No

Email

In what capacity do you know the above referee?

Emergency Contact

Name

Tel No

Relationship to you

DATA PROTECTION ACT 1998

The information on our database is strictly confidential and we do not pass on any personal data about you to outside organisations and or individuals with out your express personal consent. Please indicate if you agree that we may:

Keep basic information from this form on the computer Yes No

Send you updates and more information about Age UK East London Yes No

The information I have given is correct at time of writing. If accepted as a volunteer I agree to abide by the policies and guidelines of Age UK East London