Bright Eyes Animal Sanctuary
Volunteer Application Form
Your Details
Name
Mr/Mrs/Ms/Miss ____________________________________________________
Address ___________________________________________________________
______________________________________Postcode _____________
HomeTel:
_______________ Work Tel: ______________ Mob Tel: _____________
Email
________________________________Occupation _________________
Please tick this to confirm you are at least 16 years old
In an emergency who should we contact?
Name
Mr/Mrs/Ms/Miss __________________________________
Relationship to you
___________________________________
Phone (Primary)______________________ Phone (Secondary) _____________________
Your health
Are you physically fit?
Yes / No
Have You Had A Tetanus Booster In The Last 10 Years?
Yes / No
Please Give Brief Details Of Any Health Condition Or Special Need That Could Affect Your Ability
To Volunteer (If None, State NONE) ____________________________________________________
Volunteering Information
Please tell us what area of the sanctuary’s work you would be interested in helping out with. E.g.
Kennels, Catteries, Dog Walking etc
___________________________________________________________________________________
What is the maximum number of hours you can commit to each week? ________________
Can you commit to a specific time slot each week?
Which days of the week could you help?
________________
Mon / Tues / Wed / Thurs / Fri / Sat / Sun
Please state if you are an employee or volunteer with any other charity or organization involved in the
relief or care of animals. _____________________________________________________________
Bright Eyes Animal Sanctuary, Killymittan, Ballinamallard, Co. Fermanagh, BT94 2FW
028 6638 8885
Referee
Please supply a reference from a professional, i.e. employer, teacher, social worker, support worker.
Please do not select partners, relatives or friends as referees.
Name
________________________ Relationship to you ________________________
Address
_________________________________________________________________
_______________________________________ Postcode __________________________
Phone _________________________________ Email _____________________________
Rehabilitation of Offenders Act, 1974
You must declare any unspent criminal convictions registered against you. If none, please state “No
convictions to declare”___________________________________________________________
______________________________________________________________________________
Protecting your personal data
The information on this form will be used to process your volunteering application. If you are
successful, the information will continue to be used in connection with your volunteering for Bright
Eyes Animal Sanctuary. If you cease to volunteer for us, we may retain your information for a
reasonable period of time for evaluation purposes. By returning this signed form to us, you will be
consenting to us using your personal information in the manner above.
Agreement
People volunteering at Bright Eyes must not pursue any activity whose policies and objectives they
know or suspect are inconsistent with the objectives and policies of Bright Eyes.
All volunteers working for Bright Eyes will ensure that, in that capacity, they do not issue any
statement or otherwise act in a manner which would be contrary to the stated objectives or policies of
Bright Eyes.
Your Signature ____________________________________ Date ___/___/_____
.
1Protecting your persona
Once completed, please return this form to the address below.
Bright Eyes Animal Sanctuary, Killymittan, Ballinamallard, Co. Fermanagh, BT94 2FW
028 6638 8885