Volunteer Registration Form Volunteer with us and make a difference in your local community! Question Title * 1. Your contact information: Name Address Address 2 City/Town County Postal Code Email Address Phone Number Question Title * 2. Please tick the types of activities you are interested in supporting (full training and support is provided): Distributing HWN information Making links with local care organisations Helping to write reports Talking & listening to people about their experiences Representing HWN at meetings/events Visiting care premises Carrying out research Administrative tasks Question Title * 3. Some of our volunteer roles involve visiting premises and venues. Please tick the transport available to you: Car Bus Train Walk Bicycle Other (please specify) Question Title * 4. What type of volunteer role are you interested in: Fixed time period only Ongoing commitment Not sure yet Question Title * 5. Approximately how much time can you give each month? Question Title * 6. Please tell us why you would like to volunteer with us: Question Title * 7. What skills, knowledge and experience do you have – from home and/or work life - that you would like to offer: IT skills Office & administration Web design Bookkeeping & finance Organising & planning Languages Managing people Listening & communicating Creative arts Events & stewarding Evaluating & reviewing Social media Mental health awareness Learning disability awareness Safeguarding Child social care Adult social care UK driving licence Other skills and experience, please write here: Question Title * 8. What personal qualities do you have: I am reliable and punctual I am friendly & I enjoy talking to people I am organised I enjoy working with others I can remain impartial when talking to people I am smart & presentable I have a positive approach I am good at recording information I can handle conflict calmly Other qualities, please write here: Question Title * 9. Do you consider yourself to have a disability?* Yes No Prefer not to say *If you tell us that you have a disability, we can make reasonable adjustments to assist you in your application or with our recruitment process. We will contact you to talk about this. Question Title * 10. Please use this box to tell us about anything else you think is relevant to your volunteer registration: Volunteers will be reimbursed for out-of-pocket expenses incurred while taking part in agreed activities on behalf of Healthwatch Northumberland.Volunteers will be required to undertake a Disclosure and Barring Service check. This is free of charge for volunteers. The level of check will depend on the nature of the volunteer role. You can find a link to our Volunteering Policy here: https://healthwatchnorthumberland.co.uk Information provided on this form will be used to process your volunteer registration and will be protected and treated securely in accordance with the Data Protection Act (1998) and the General Data Protection Regulation (GDPR) & Data Protection Bill. Done