Volunteering Application Form
1. Role details:
If you are making a speculative application leave blank and complete section 4 below.
Role Applied For:
Role Reference:
Date of Application:
2. Personal Details:
This information will be used to communicate with you. Please check all information is correct.
Title:
Surname:
First names:
Address:
Town:
Tel:
Postcode:
Mobile:
Email:
Date of birth:
Certain roles require the volunteer to be over 18. Please refer to the role advertisement or contact
the volunteer office if you have any questions. All applicants must be over 16.
The volunteer office usually communicates through email. If you would prefer to be contacted via
a different means, please tick the relevant box:
Telephone ☐ Post ☐
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3. Personal Statement
Please use this box to tell us why you are applying to volunteer at the Royal National
Orthopaedic Hospital and what interests you about the role.
Please tell us about your skills and experience, including the skills that you think makes you
suitable for the role for which you are applying. You may want to include any relevant
employment history or qualifications.
4. About Your Interests
If you are unsuccessful in your application, we may have other roles suitable for you. Please
indicate by ticking the relevant box whether you have experience in any of the following areas:
Admin / office work (filing, databases, email enquiries, general IT)
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Befriending / patient support (entertaining, listening to patients, support)
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Cleaning / hygiene services (including laundry, general cleaning procedures)
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Customer service (including advice, sales, support, networking)
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Specialist IT (including design, databases, systems)
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General maintenance and trade work (including repairs, construction)
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Play and nursery support (including experience of teaching)
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Working with people with learning, mental health, and physical difficulties
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5. Your Availability
Some roles may have specific requirements regarding what days and times volunteers are needed.
Other roles may be more suitable for your availability. Please use the table below to let us know
when you are able to volunteer. We would not expect you to volunteer on every day you tick!
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Morning
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Afternoon
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Evening
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The majority of roles require a minimum attendance of 4 hours a week in a single
session. Please confirm you can make this commitment by ticking the box:
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We ask for a commitment of 1 year from our volunteers. Please confirm that you can
make this commitment by ticking the box:
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6. Accessibility
Please use the box below to inform us of any individual requirements you require to access our
services:
7. Further Information
Please use this box to tell us anything else you think may be relevant to your application
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7. References
We require two references prior to you starting as a volunteer. References should have known you
for at least two years and not be relatives. References can include teachers, religious leaders,
doctors, employers, or community leaders. References may include family friends if you are
unable to name two from the suggested groups above. If you require any advice or assistance in
choosing references, please contact the volunteer office.
Reference 1
Reference 2
Name:
Relationship to you:
Company or
organisation (if
applicable):
Address:
Telephone:
Email:
8. Emergency Contact
Please provide details of next of kin who can be contacted in case of emergency
Name:
Contact number:
Relationship to you:
9. Declaration
Due to the nature of the Trust’s work, voluntary roles are exempt from the provisions of the
Rehabilitation of Offenders Act. You must not withhold any information about convictions
(including those considered ‘spent’), previous or pending prosecutions, cautions or bind overs
applicable in either the UK or abroad.
A conviction, previous or pending prosecution, caution, or bind over, will not necessarily prevent
you from being successful, unless these mean you are unsuitable for a particular post.
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Failure to disclose a conviction, previous or pending prosecution, caution, or bind over, either in
this country or abroad will disqualify you from appointment. If a discrepancy comes to light at a
later stage, it could result in dismissal from the Trust.
All successful applicants will be checked by the Disclosures and Barring Service for Enhanced
Disclosure prior to commencing their volunteering work.
Are you current bound over or have you ever been convicted of a criminal offence, cautioned,
warned, or reprimanded in the UK or in any other country?
Yes ☐ No ☐
Are you aware of any current police investigation in the UK or any other country following
allegations made against you?
Yes ☐ No ☐
Does your name appear on the Protection of Children Act List?
Yes ☐ No ☐
Are you legally entitled to volunteer in the UK? Please contact the UK Border Agency if in doubt.
Yes ☐ No ☐
If you have answered yes to any of the above questions please use a separate sheet to give details.
In accordance with the Data Protection Act (1998), it is agreed that the Royal National
Orthopaedic Hospital Trust may hold and use personal information about me relating to my
volunteering with the Trust and to keep in touch with me. This information can be stored in both
paper and digital format, including the data in section 2 of the Data Protection Act 1998.
I understand that I will be asked to produce evidence of identification, address, and status in the
UK when applicable.
I declare that the information given on this form is true and accurate. I understand that any false
information may result in the withdrawal or termination of a voluntary offer or role.
Your Signature:
Date:
Please return all forms to volunteering@rnoh.nhs.uk
Or post to:
Volunteer Services
Royal National Orthopaedic Hospital
Brockley Hill
Stanmore
Middlesex
HA7 4LP
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