Volunteer Application Form - Victim Support NI

Please click the box of the service(s) you would like to be considered for: *

Community Service

Witness Service

About You

Name *

First Name

Surname *

Surname

Address Line 1 *

Address Line 2

Address Line 3

Postcode *

Home Phone *

Mobile Phone

Email Address *

Are you 18 or over? *

1. How did you first hear of volunteering with Victim Support NI? *

If you spotted the opportunity via Facebook, local newspaper or poster, and you noticed the Reference Code, please state it here:

2. Why would you like to volunteer with Victim Support NI and what do you hope to gain from the experience? *

3. Please provide some information about your previous experience of supporting people – this may be in a work, voluntary or personal setting. *

Do you have a current driving licence and use of a car? *

Are you able to use public transport? *

How far from the address in this application are you prepared to travel on a regular basis? *

Distance in miles

Are you able to provide the minimum commitment?

Community Service – 4 hours per week

Witness Service – 1 day per week

(Monday – Friday)

What days and times are you available to volunteer?

This will be used to match you to a volunteer role. If you cannot meet the minimum time commitment required above, we will contact you about any other roles that may suit your availability as and when they become available.

Can you communicate in sign language? *

Can you speak a language other than English? *

If yes, what language?

Referee 1

Referee 1: Name *

Referee 1: Email *

Referee 1: Phone *

Referee 1: Address 1 *

Referee 1: Address 2

Referee 1: Address 3

Referee 1: Postcode *

Referee 1: In what capacity do they know you? *

Referee 2

Referee 2: Name *

Referee 2: Email *

Referee 2: Phone *

Referee 2: Address 1 *

Referee 2: Address 2

Referee 2: Address 3

Referee 2: Postcode *

Referee 2: In what capacity do they know you? *

Criminal Record Check

Owing to the sensitive nature of our work with “vulnerable groups” Victim Support requires all prospective volunteers to disclose criminal convictions, cautions or bind-overs. Unprejudiced consideration will be given to applicants who disclose these, unless, they are manifestly incompatible with the role in question.

Victim Support NI adheres to Access NI’s code of practice (a copy of which can be made available on demand). This information will be held in strict confidence. Where applicable appointments of prospective volunteers are subject to Access NI clearance. A risk assessment will be conducted if any information is disclosed on an Access NI Disclosure Certificate to assess the suitability of appointment.

Have you ever been convicted of a criminal offence? *

If "yes" please provide details of your criminal record *

Before we can progress your application, we must carry out an assessment of the risk to the organisation and our clients of appointing any volunteer with a criminal record. In order to help us, please provide details about your criminal record including what the convictions were, what sentence / sanctions you received, when the convictions were made and any other information you wish to provide about the convictions. We may need to contact you for further information in order to complete our risk assessment.

Is there any reason why you cannot work in “Regulated Activity” as defined by Safeguarding Vulnerable Groups Order 2007 (SVGO) and as amended by the Protection of Freedoms Act 2012 (PoFA)? *

Declaration

Declaration *

I declare that the information given on this form, and on any accompanying documents, is true to the best of knowledge and belief. I agree to my details being passed to Access NI in order for a Criminal Records check to be carried out and that the result, including a copy of any cautions, convictions or bind overs, will be disclosed to Victim Support in confidence. I consent to Victim Support holding the data I have provided and agree to my equality monitoring data being retained for monitoring purposes.

If you are human, leave this field blank.