NHC Volunteer Application Form

Thank you for your interest in becoming a volunteer. Please answer the questions below in order to begin the application process. 

About You

First Name

Last Name

Preferred name / Nickname

Email

Phone number

Date of birth

Ethnicity

Please select... Asian (a) British Asian (b) Indian Asian (c) Pakistani Asian (d) Bangladeshi Asian (e) Chinese Asian (f) Any other Asian background Black (a) British Black (b) African Black (c) Caribbean Black (d) Any other Black background White (a) British [English/Welsh/Scottish/Northern Irish] White (b) Irish White (c) Roma, Gypsy or Irish Traveller White (d) Any other White background Mixed (a) White and Black Caribbean Mixed (b) White and Black African Mixed (c) White and Asian Mixed (d) Any other mixed ethnic background Other (a) Arab Other (b) Jewish Other (c) Any other ethnic group Unknown Prefer not to say

Gender

Please select... Woman / Trans Female Man / Trans Male Non-binary Prefer not to say Self-defined

Employment status

Please select... F/T Employed P/T Employed Unemployed F/T education P/T education F/T parent F/T carer Retired

If employed, what is you job?

Your Skills and Specialities

Tell us a bit about your career background

Tell us about any special skills you have e.g. can speak multiple languages

Your preferred language

Do you have a full UK driving licence

YesNo

Volunteer Admin

What areas could you work in?

Moss SideHulmeRusholmeLongsightArdwick

What hours are you available to volunteer?

A DBS check is part of the recruitment process. Are you happy to do a DBS check? This is free.

YesNo

Contact and Consent

What is the best way to contact you? For example, text, call, email or WhatsApp

Please select... Mobile Landline Text Email WhatsApp

Please provide us emergency contact details (name & number)

Are you happy to use your photos for publicity, promotion and social media by Neighbourhood Health Champion coordinators?

YesNo

Consent: 
The information on this form will be securely stored according to our GDPR policy.
Please enter today's date in the box below to show you understand this. 
If you have any questions about how we use your data, please contact: manager@msmpowerhouse.org.uk