Thank you for your interest in applying to volunteer with the Imperial Health Charity. Please fill out this self-assessment form as part of our risk management process. In the interests of confidentiality, the only information made available to the Volunteering Department is your contact information and final score. 

PLEASE NOTE - this is not an application to volunteer. Depending on your score, we will contact you with instructions on how to submit a full volunteer application form online.

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* 1. Full Name

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* 2. Email Address

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* 3. Telephone Number

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* 5. Which is your biological gender?

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* 6. What is your age?

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* 7. What is your ethnicity?

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* 8. Are you on the clinically extremely vulnerable list?

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* 9. Are you on the clinically vulnerable list?

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* 10. How long do you need to travel on public transport to get to your preferred volunteering site?

At the end of the survey it may have a red cross by some of your answers. This is fine, please scroll to the bottom of the page and press 'done' again and it will submit your survey. 
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