Person to notify in case of emergency
Please provide two referees over the age of 18 years. Please note that these can not be family members or friends.
(If you are having difficulties providing suitable referees, please email email@example.com)
Any information you supply on this form is confidential and will only be used in respect of your voluntary placement in line with the Data Protection Act 1998. By submitting this application form you consent to St Luke’s Hospice using this information for this purpose. Any information given will be considered only in relation to applications for positions covered by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975.
Applicants are not entitled to withhold any information about criminal convictions, however long ago these occurred. Failure to disclose such convictions could result in being released from a volunteer role.
Communication from St Luke's
Agreement and Signature
I confirm that the information supplied is accurate and that I have not knowingly withheld any information which is relevant to the application. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may preclude me from volunteering for St Luke’s.
St Luke’s Hospice welcomes volunteers without regard to race, colour, religion, national origin, gender, sexual preference, age, or disability.