Volunteer Referral Form 

Please fill in the form as much as you can, do the best you can. When we receive the form, we will be in touch.
Volunteer Referral Form

1. Your Details

2. How did you find out about the Volunteer role?**

3. What type of support can you offer?**

4. What interests, hobbies and skills do you have?

5. When can you volunteer?

6. In-person Support

The service is intended to be remote (video calls) however some members may ask for in-person support. You do not have to offer this support and we will pay agreed travel expenses.

If you are willing to offer in-person support, how would you travel to visit service users? If you do not wish to offer in-person support, you do not have to answer this question. 

7. Do you have a criminal record?

Protecting Children and Adults

Please be aware that some of our volunteering roles require a Disclosure and Barring Service (DBS). Some criminal offences will not bar you from volunteering with us and we will decide on an individual basis.

However, offences including any form of violence, theft or blackmail will automatically disqualify you from volunteering to support vulnerable adults or children.

8. References

Please include 2 references that we can contact after your informal assessment.

One of your references should be someone who knows you in a professional capacity, such as work, volunteering or education.

1st Referee

2nd Referee

9. Emergency Contact

This must be completed if you would like to support people in-person.

10. Equality and Diversity

Self Help Nottingham and Deaf Cancer Support aims to be open and inclusive to all. We welcome diversity in our team and will make all reasonable adjustments to support anyone volunteering with us.  We will try to provide access, equipment, or other practical support to ensure that our volunteering opportunities are accessible as possible. We work within the Equalities Act 2010 and welcome volunteers from all backgrounds and circumstances.

11. Ethnicity **

The questions below are for us to monitor the diversity of our volunteering team to ensure that we are representing the communities we work in. You are under no obligation to complete the questions, but it would help us to continue working to make our service accessible to as many people as possible.

12. How would you describe your gender identity?**

13. How would you describe your sexuality?**


SORD (Social Research with Deaf People)

Some of this information (marked with **) will be shared with Social Research with Deaf People (SORD) who are evaluating this project, but only if you have consented to take part in the evaluation study.

SORD would like to send you some information about the evaluation study so that you can decide if you want to take part. 

This information is in BSL (and English) - https://www.deafcancersupport.org.uk/evaluation

If you tick 'Yes' it means that we will pass on your email/contact details to SORD. We will NOT pass on any other information about you.

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