Please enter your details , then click the submit button. Fields marked with an asterisk are compulsory.
1. Contact Information
*Title
*First Name
*Surname
*Address 1
Address 2
*Town
*County
*Postcode
Telephone
*Email
Mobile Phone
2. Emergency Contact Information
*Name
Telephone
*Address 1
Address 2
Relationship
3. How did you hear about vinvolved? (Select one only)
TV/Radio
Church
vinvolved staff
Friend
Connexions
Another Organisation
University
Job Centre
Leaflet / Poster
Other
School / College
4. Areas of Interest (Select all that apply)
Animals
Homeless & Housing
Art & Culture
Human & Civil Rights
Children
International Aid
Disability
Legal Aid & Justice
Disaster Relief
Mental Health
Domestic Violence
Mentoring
Drugs & Addictions
Museums
Education & Literacy
Music
Elderly
Politics
Emergency Services
Prisoners & Ex-Offenders
Employment
Race, Ethnicity & Refugees
Environment
Religion
Families
Sport & Outdoor Activities
Gay, Lesbian, Bi & Transsexual
Women's Groups
Health, Hospital & Hospices
Youth
Heritage
5. Type of Activity (Select all that apply)
Administration
Gardening
Advice, Information & Support
General & Helping
Architecture & Building Work
Hostel Work
Art
Languages
Befriending & Buddying
Legal Work
Business, Management & Research
Local Events
Campaigning & Lobbying
Marketing, PR & Media
Caring
Mentoring
Catering
Music
Community Work
National & International Events
Computers, Tech. & Web Design
Officials
Counselling
Practical Work & DIY
Driving
Retail & Charity Shops
Employee & Group Volunteering
Sports Development
Entertainment
Teaching, Training & Coaching
Finance Work
Trusteeship & Committee Work
First Aid
Under 16 Volunteering
Fundraising
Youth Work
6. Voluntary or Past Work (Please enter any relevant experience)
7. When are you free to volunteer? (Select all that apply)
All
Sat
Sun
Mon
Tue
Wed
Thu
Fri
Morning
Afternoon
Evening
8. Date of Birth
Day
Month
Year
--------
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
--------
January
February
March
April
May
June
July
August
September
October
November
December
--------
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
9. Gender
Male
Female
10. Which of the following forms of volunteering are you interested in? (Select all that apply)
Short-term / One-off Projects
Part-time
Full-time
International
11. Have you been a volunteer in the last 12 months?
Yes
No
12. Geographical Area – Where would you like to volunteer? (Select all that apply)
Solihull
North Warwickshire
Nuneaton & Bedworth
Rugby
Warwick & Leamington District
Stratford District
All Warwickshire
13. Preferred Method of Future Contact (Select one only)
Email
Phone
Post
Text
Equal Opportunities
v
involved aims to include young people from across the community. The following information is required to help us ensure that we are delivering the project in line with our Equal Opportunities policy.
14. Ethnicity (Select one only)
Asian or Asian British
Dual Heritage
Indian
Black Caribbean & White
Pakistani
Black African & White
Bangladeshi
Asian & White
Other Asian background
Roma and Travellers
Black or Black British
Roma
Caribbean
Irish Traveller
African
Other Traveller
Other Black background
White
Chinese
White British
Chinese
White Irish
Other ethnic group
Other White background
Other
Prefer not to say
15. Disability (Select all that apply)
Learning difficulty
Multiple disabilities
Learning disability
Physical disability
Long term or life-limiting illness
Sensory disability
Mental health issues
Prefer not to say
16. Education (Select highest level)
No Qualifications
Degree
Below Level 2 (< 5 GCSE grades A-C incl. Maths & English)
Post-graduate
Above level 2
Other
NVQ or equivalent
Prefer not to say
A-Level
17. Employment, Education, Training Status (Select one only)
Employed
Not in employment, education or training
In education/learning
In training
Self-employed
Other
Prefer not to say
18. Sexual Orientation (Select one only)
Bisexual
Lesbian
Gay
Other
Heterosexual
Prefer not to say
19. Additional Information (Select all that apply)
Low income
Refugee/Asylum Seeker
Homeless
Lone parent
At risk of exclusion
Young carer
Offender/Ex-offender
Young parent
In or leaving care
Prefer not to say