Name of Organisation

Address

Tel

Fax

E-mail

WWW Homepage

Company Reg no. (If applicable)

Charity No. (If applicable)

Contact Person

Position in organisation/Job Title

Give a brief description of the aims and work of your organisation

Is it a non-profit making organisation?

How is the organisation funded?

Staffing

No. of full time staff

No. of Part time staff

No. of Jobs initiative and CE Staff

No. of volunteers working within organisation

No. of Volunteers on management committee

No. of Volunteers required

(Please note - if you require volunteers for different roles please submit separate applications)

What will the role/title of the volunteer be?

Is this work currently being undertaken in your organisation?

If yes, by whom?

What specific tasks will the volunteer be expected to undertake?

Are there any particular sklls and personal qualities necessary for this position?

Is there a minimum length of committment required?

Which days and at what times per week/month do you require voluntary assistance?

	Mon	Tues	Wens	Thurs	Fri	Sat	Sun
AM
PM
Evening

Other times/further details

At what address will the volunteer be working?

Does your organisation have a volunteer policy?

Does your organisation have a childcare policy?

Will the volunteer receive any of the following?

Yes No Support/Advice/Recognition

Yes No Supervision

Yes No Training (induction and ongoing)

Yes No Insurance cover

Yes No Reimbursment of out-of-pocket expenses

Do you require references for volunteers?

Do you undertake any other screening procedures?

Yes No

If yes, please give details

Do you wish to have some details of your organisation published on our web page?