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Application to become a DCHS volunteer

Please complete this application form and check it carefully before pressing submit.

We will review your form and get in touch to make sure we understand what you are looking for and there is a volunteer vacancy that matches your request.

If we are able to progress your application you will then be asked to complete an equality, diversity and inclusion monitoring form.  This enables us to ensure we are recruiting fairly and representing the diversity in our community.

About you

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Your address
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Volunteer role

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Pre-volunteering Health Declaration

In order to ensure compliance with pre-placement checks required within the NHS, with current disability legislation and to ensure that DCHS provides you with any support during your work experience we need you to respond to the following statement.  

**Conditions which may be relevant include back injury, skin disease, epilepsy, diabetes or psychological illness.   

If 'yes', we will discuss your particular situation and any reasonable adjustments at the next stage of the application process.

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References

Who should you ask to be your referee? We suggest this is your previous employer/volunteer supervisor, a religious or cultural leader, teacher or tutor, case worker, social worker or community leader.

Referee 1

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Address
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Referee 2

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Address
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Rehabilitation of Offenders Act 1974

The Rehabilitation of Offenders Act 1974 (as amended) helps rehabilitated ex-offenders back into work by allowing them not to declare criminal convictions after the rehabilitation period set by the Court has elapsed and the convictions become 'spent'. During the rehabilitation period, convictions are referred to as 'unspent' convictions and must be declared to employers.

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Agreement/signature of volunteer applicant

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DCHS Volunteer Demographic Information Request

NHS England would like to collect information on volunteers who support the NHS. If you consent to completing the form , your volunteer information will be shared anonymously with NHS England every 3 months. Your volunteer data will be securely stored and protected and will be deleted 12 months after you stop volunteering for us. You can decline to provide this information.