Application to volunteer

Thank you very much for your interest in volunteering for Alzheimer
Scotland. If you fill in this form it will be e-mailed to us and sent
to the appropriate person according to your interests and area. We will
contact you to discuss your application.


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


MonTueWedThurFriSatSun
morning
afternoon
evening
overnight (for Helpline)

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


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

Referee 1

Name

Address




Telephone (day)

Telephone (evening)

Email

Referee 2

Name

Address


Telephone (day)

Telephone (evening)

Email



Rehabilitation of Offenders Act


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




Thank you very much for applying to be an Alzheimer Scotland volunteer. We will be in contact with you as soon as possible.

24 hour Dementia Helpline
Freephone 0808 808 3000
 
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Alzheimer Scotland - Action on Dementia is a company limited by guarantee, registered in Scotland 149069. Registered Office: 22 Drumsheugh Gardens, Edinburgh EH3 7RN. It is recognised as a charity by the Office of the Scottish Charity Regulator, no. SC022315.

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