Volunteer Application Form Title MrMrsMissMs Full Name Preferred Name If not applicable, simply type "N/A". Address Email Address Contact Number Date of Birth Ethnicity Emergency Contact Details This information will only be used in the event of an accident, sudden illness or civil emergency whilst engaged under an activity operated by Feeling Fab. Emergency Contact Number Relationship Contact Number Volunteer Declaration 1. Please list any health-related issues that may impact on your ability to effectively perform the tasks and responsibilities of your duties as a volunteer? 2. Please list any specific skills, training, interests or work experience that you believe may influence the area where you are assigned, including previous volunteer experience? 3. Do you speak any language other than English? 4. Have you ever been convicted of a criminal offence (within last seven years)? YesNo Please supply further information on the charges you have been convicted of. 5. Are you awaiting a criminal court hearing or undergoing disciplinary action? YesNo 6. Do you give consent for Vetting/Police Check? YesNo Referee Request It is our policy to verify the suitability of all new volunteers. Please supply the names and addresses of TWO referees who will be willing to support your application to become a volunteer? Please choose people who have known you for at least two years, but who are NOT immediate family. Referee #1 Name Relationship Address Contact Number Referee #2 Name Relationship Address Contact Number General Declartion By clicking/pressing the below "Register to Volunteer" button, I confirm that all details supplied on this form are true and complete to the best of my knowledge and I recognise that failure to declare any relevant information or to supply the details required may result in my volunteer role with Feeling Fab be discontinued. I understand that the information on this form will be held securely on the Feeling Fab database and on paper in the Feeling Fab office. I understand that Feeling Fab will endeavour to place me in an activity that relates to the skill I have advised, but I may need to step in and help out in a different activity depending on what is required on the day.