Volunteer Application

First name *
Last name *
Email address *
Phone number *
Address *
Postcode *
What is your date of birth? *
Are you up to date with your Tetanus vaccination? * Please note that you must be up to date with your tetanus vaccine before being able to volunteer
Do you have any allergies or illnesses that we need to be aware of? *
Please state and explain any information that we will need to be aware of prior to your induction * Please note any regular medication you may be taking and what they are for.
Do you have any additional support needs? *
Please state and explain these needs to us. * Please be aware due to the physical nature of our roles and accessibility of some of our locations we may be unable to accommodate you.
Do you have a current full UK driving license? *
Do you have the use of a car? *
Do you have a criminal record? * Declaration subject to the Rehabilitation of Offenders Act 1974.
Please provide details *
Emergency contact details This person will be who we contact in cases of emergency.
First name of your emergency contact *
Last name of your emergency contact *
Emergency contact number *
What is the address of your emergency contact? *
Postcode *
What is their relationship to you? * e.g. Mother or Partner etc.
Please tick which days you would be willing/able to volunteer *	Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Please specify how frequent you would be able to volunteer for us * e.g. Once a week or every other week etc.
Please specify what hours you would be able to volunteer for. * e.g. I can volunteer on Mondays and Fridays from 9am-1pm but can also volunteer on Sundays from 2pm-4pm
Areas interested in:
Please select each of the options that you would be interested volunteering with us for. *
If there are any other fields that you would be interested in volunteering with us for, please suggest them here.
Volunteering Experience
Please list the experience you have as a volunteer, this can include your position and responsibilities, as well as the organisation you volunteered for and when you volunteered there
References
Please provide at least two from any previous experience/employment Please state the Name/Position of the reference as well as a method of communication that we can use to contact them.
Volunteer waiver, indemnity and consent (agreement) In consideration of being permitted to volunteer at Wythall Animal Sanctuary, I, the undersigned, voluntarily agree to the following: 1. I agree to conduct myself in a courteous and professional manner as a volunteer and representative of Wythall Animal Sanctuary and I will treat all the animals with the highest respect. 2. I agree to follow all Wythall Animal Sanctuary policies and procedures and abide by all instructions from the staff. 3. I agree that my volunteering services to Wythall Animal Sanctuary are performed on a voluntary basis without pay, without medical or worker’s compensation insurance and without compensation of any kind. I understand that all of my volunteering services are performed at my own risk. I agree that it is my responsibility to act in such a manner as to be responsible for my own safety whilst volunteering. 4. I authorise Wythall Animal Sanctuary to contact the emergency contact on this application and seek emergency medical care in case of my accident, illness or injury. 5. I have disclosed all relevant medical conditions in this application and will advise Wythall Animal Sanctuary of any changes e.g. pregnancy. I acknowledge that Wythall Animal Sanctuary strongly insists that I keep up to date with my tetanus vaccinations and to advise my doctor that I may be handling animals. I agree that all vaccinations, medical care and medications are my own responsibility and I release Wythall Animal Sanctuary from all responsibility with respect to same. 6. I give Wythall Animal Sanctuary exclusive right to use, publish or reproduce any photographs, drawings, writings and or any copyrightable material produced of me or by me as a volunteer. 7. I agree to keep confidential indefinitely all Wythall Animal Sanctuary records and information regarding previous and new owners of Wythall Animal Sanctuary animals. 8. I agree that Wythall Animal Sanctuary may refuse or terminate my participation in its volunteer programs at any time without notice. 9. I acknowledge the risks and dangers inherent in handling animals and in otherwise volunteering with Wythall Animal Sanctuary and I freely assume and fully accept these risks. I understand that I will receive a full induction and training in Health and Safety before starting volunteering. I am aware that Wythall Animal Sanctuary has public liability insurance in place up to the limit of £5,000,000. 10. I agree to this waiver, indemnity and consent on behalf of myself, my heirs, executors and assigns
Are you over the age of 18 years old? *
Parent/Guardian Consent form
Title *
First name *
Last name *
Address *
Postcode *
Contact number *
Relationship to you *
Please sign the digital signature box below.
I confirm that I have read the role description and guidance for the role that the applicant is applying for and I give consent for them to volunteer with Wythall Animal Rescue if their application is successful. I confirm that I am happy to be contacted in the event that any problems arise during the course of their volunteering. *
I understand that Wythall Animal Sanctuary will use my information for administration and management purposes in accordance with the Data Protection Act 1998. I understand that if I am successful in my application my application my information may be disclosed to Wythall Animal Sanctuary employees or Emergency Services personnel if necessary. I understand that I will be asked to attend an induction if I am successful for this role
Please sign the digital signature box below.
Declaration * I confirm that the information given on this form is wholly accurate information at the time of submission. Any false statement may be sufficient cause for rejection or dismissal.