OMD Bookings

Title *

First Name(s) *

Surname *

Other names you have been known by

Date of Birth *

Address *

Post code *

Home phone

Mobile phone *

Email address *

What is your preferred method of contact? *

Home Telephone

Mobile Phone

Visa expiry date

Do you require a work permit to work in the UK? *

Yes

RELEVANT EXPERIENCE

Do you hold a clean current UK driving licence? *

Yes

Are you currently employed? *

Yes

Previous voluntary work? *

Yes

Main duties performed

What role or main area of interest

On which days might you be available to undertake this voluntary role (please select)?

We ask for a minimum of 4 days per month

Day	Additional Information
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

When would you be able to start volunteering?

How long will you be able to volunteer for?

Do you have any specific requirements that we need to be aware of? *

Yes

Have you visited OMD Farm before? *

Yes

HOW DID YOU HEAR ABOUT US?

REFERENCES

Please give details of two referees who we can contact. These can be work related referees, education related referees or character referees. Please note, we will not contact referees until a voluntary position is offered.

Reference 1

Name

Relationship to you

Email Address

Address

Reference 2

Name

Relationship to you

Email Address

Address

DISCLOSURE OF CRIMINAL RECORD

Disclosure of any criminal conviction(s) will not necessarily mean you will not be successful in your application - this would depend on the nature of the offence(s) and their relevance to this appointment. Failure to declare previous convictions may prevent your association with OMD Farm if it subsequently becomes apparent that you do, in fact, have a criminal record.

Do you have any criminal convictions? *

Yes

If your volunteering will bring you into regular contact with children or vulnerable adults, we may also require you to disclose all previous convictions, even when they are ‘spent.’ You would also need to seek a DBS check. If this is the case for the voluntary role you are undertaking, we’ll let you know.

PLEASE READ THE FOLLOWING DECLARATION CAREFULLY

I declare that the information given in this application is to the best of my knowledge complete and correct. I understand that OMD may seek verification of any information provided. I understand that if it is discovered that I have given false information the voluntary position I have been offered may be withdrawn.

I agree to OMD Farm using the information contained in this form for the proper administration of its business and should I be successful I agree that the information will be used as part of the voluntary relationship.

Volunteer application

PERSONAL DETAILS