Volunteer Application Form

Thank you for choosing to volunteer at Garden House Hospice Care. This application form will help us collect all of the information we need to make sure you have a good volunteering experience with us. All of your information will be kept securely and we will never pass on any personal details to third parties.
Read our privacy policy here.
Personal Details

This should be your legal name


Please let us know if you are known by a different first name






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Select date from calendar or input date in DD/MM/YYYY format
Under 18 Volunteer Application Form



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Please note, if you are aged 14 - 15, we can only accept your volunteer application as a part of the Duke of Edinburgh volunteer scheme.

At present this is the only volunteer scheme for which we are accepting applications. If you are aged 14 or 15, we can only accept volunteer applications as part of the Duke of Edinburgh scheme. DofE places are limited, and an application does not guarantee a place.

Parent / Guardian declaration







Gardening
The information in this section helps us make your volunteering experience as smooth as possible. Please give as much information as you feel is necessary / relevant:


We endeavour to support any volunteer to help in the garden, this info is useful so we know what support might be needed or what tasks can be carried out.
Depot Volunteer
The information in this section helps us make your volunteering experience as smooth as possible. Please give as much information as you feel is necessary / relevant:


We endeavour to support any volunteer to carry out their role, this info is useful so we know what support might be needed or what tasks can be carried out.
Shop Volunteer
The information in this section helps us make your volunteering experience as smooth as possible. Please give as much information as you feel is necessary / relevant:

Admin / Reception Volunteer
The information in this section helps us make your volunteering experience as smooth as possible. Please give as much information as you feel is necessary / relevant:

IPU - Compassionate Neighbour
We have Compassionate Neighbours based in the hospice in-patient unit (IPU) who are there to offer social and emotional support to patients and their friends and family. If you would like to become an IPU Compassionate Neighbour you will need to attend an intro session here at the hospice. A member of the Compassionate Neighbours team will be in touch to give you the details. 

References
Please provide details of two referees that have known you for at least 12 months. These can be teachers, employers, friends, neighbours etc. They must be over 18 years of age and should not be members of your family.

Please provide email addresses for both of your referees - this is the easiest way for us to collect this information as an email will be sent to each referee asking them to complete a very short form. You can submit the form with just one email, if required. If you don't have at least one email address, please give us a call on 01462 679540.

1st Reference




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2nd Reference 




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Emergency Contact Details



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Medical Information


Equal Opportunity Monitoring Information
Garden House Hospice Care is committed to providing equal opportunities and fair treatment for all volunteers. In order that we can monitor our success in meeting this commitment, please help us by completing the following equality and diversity information. Your responses will be treated as strictly confidential and will not be used to assess your suitability as a volunteer. The data is being requested for monitoring and statistical purposes only and will be used to provide an overall profile analysis of our volunteers to assist the hospice in meeting statutory and other obligations. You do not have to complete this section if you do not wish to do so.



We recognise that people may have more than one type of impairment / condition, in which case please indicate all that apply.
















How Did You Hear?



Additional Information


Volunteer Declaration

Garden House Hospice Care Statement of Confidentiality

Media Consent