Name: ____________________________________________________

Address: ____________________________________________________

________________________Tel: ________________________

Age Group: 20 or under ________ 21 to 30 ________

31 to 40 ________ 41 to 50 ________

51 to 60 ________ 61 or over ________

Do you have any particular relevant skills?
Such as window dressing, a knowledge of antiques & collectables, valuation of books etc? Give details.
_____________________________________________________________________

_____________________________________________________________________

Tell us about yourself.
What are your interest & hobbies? Do you have any pets? What work experience do you have?
____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

Do you suffer from any health problems?
Such as Asthma, Diabetes, Epilepsy or Back Problems? Please give details.
____________________________________________________________________

____________________________________________________________________

Is there anything that you would refuse to do in a normal shop environment?
Please give details.
____________________________________________________________________

____________________________________________________________________

Would you like to help with the following?

Fundraising ___________ Helping at Events ____________

Please let us know your:

Next of kin ____________________________ Tel ________________

Doctor ____________________________ Tel ________________

When are you available to work in the shop?

Mondays _____ Thursdays _____
Tuesdays _____ Fridays _____
Wednesdays _____ Saturdays _____

When would you prefer to work?

09:30 to 13:00 _________ 13:00 to 16:30 _________

We are delighted that you are applying to join us as a volunteer in our charity shop on Victoria Road. All volunteers with the RSPCA are asked to provide the names of two people who have known you for a minimum of two years and can give a reference. The people may be an employer, former colleague, teacher or a neighbour but not a relative.

Title: ________ Surname: _____________________ Initials: _______

Address: _____________________________________________________________

Tel: ____________________ How are you associated? __________________

Title: ________ Surname: _____________________ Initials: _______

Address: _____________________________________________________________

Tel: ____________________ How are you associated? __________________

I am happy for you to contact the persons named above for references.

Signature: ________________________________ Date: _______________