Application to volunteer

Name

Address

Postcode

Telephone number (day)

Telephone number (evening)

Email address

Which volunteer activities are you interested in? (You can choose more than one)

working in a local day centre or drop-in

volunteer driving

befriending someone with dementia

Dementia Helpline

organising events

taking part in events

one-off help

Do you have a current driving license? Yes No

Do you have access to a car? Yes No

Previous work experience paid or voluntary

Do you have any other life experience you would consider relevant
to voluntary work with Alzheimer Scotland (for example, caring for someone,
fundraising or other voluntary experience)? Not every volunteer has
this sort of experience, but we’d like to know about it if you do.

Please say why you are interested in volunteering.

Days and times available

All volunteers for Alzheimer Scotland are required to undertake training. Yes No

Please give details of two referees (not related to you)

Name

Address

Telephone (day)

Telephone (evening)

Email

Name

Address

Telephone (day)

Telephone (evening)

Email

You must read this section if you are applying for any voluntary work with us, except for organising events, taking part in events or one-off help.

The Rehabilitation of Offenders Act 1974 allows people who have been convicted of certain criminal offences to regard their convictions as ‘spent’ after a period of years. This means that, in general, they do not need to tell anyone about the conviction or any circumstances relating to it.

Because of the nature of voluntary work with vulnerable people, however, it has been excepted from the provision of the Act. This means that you must tell us about convictions which for other purposes are ‘spent’ under the Act. If you become a volunteer and failed to tell us about a conviction, we may dismiss you. Any information you give is kept confidential and considered only in relation to this application.

I have read and understood the above and have nothing to disclose

I have read and understood the above and wish to disclose the following information