This is not an application form. This form is for registering your interest in volunteering for basis. This is not an application form. This form is for registering your interest in volunteering for basis. I Understand

First Name

Last Name

Address

Town

County

Post Code

Preferred Contact Number

Other Contact Number

Email Address

Availability Availability 1-2 Hours Weekly 2-4 Hours Weekly 4-5 Hours Weekly 5+ Hours Weekly 10+ Hours Weekly

Area of Interest Area of Interest Befriending Arts & Crafts Computers

Information on our database is strictly confidential and we do not pass on any personal data about you to outside organisations and/or individuals without your express personal consent. Please tick to indicate that you agree that we may keep the information from this form on our systems and use it to contact you regarding your application Information on our database is strictly confidential and we do not pass on any personal data about you to outside organisations and/or individuals without your express personal consent. Please tick to indicate that you agree that we may keep the information from this form on our systems and use it to contact you regarding your application I agree