Volunteer Application Form

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All details submitted to FareShare are held in the strictest of confidence in accordance with
the Data Protection Act 1998.

Once completed please e-mail this form to:

volunteer@faresharesouthwest.org.uk

Or print, complete & post to:

Volunteer Manager
FareShare South West
Unit 4, Little Ann Street
Bristol
BS2 9EB

Contact Information:
Surname:
Yates

Forename:
Tom

Address:
26 Neath Road
BS5 9AP
Bristol

Home/mobile phone no: Work phone no: E-mail address:

07427 330914 tomdev@protonmail.com

General Information:
Please tick the volunteer role in which you are interested (you may tick more than one)

Day to day operations in x

the warehouse
Administration duties
Driver
Food delivery and
collection courier (cyclist)
Please indicate when you are available and the number of hours you would like work-
Please note: We normally ask for volunteers to be able to commit to at least one full day a
week, but in certain circumstances we can be flexible.
EVENING
9am-5pm (5-8pm Mon & Wed)
Monday x
Tuesday
Wednesday
Thursday
Friday

General:
When would you be able to start volunteering? As soon as possible

Have you ever been convicted of any offence, which is not considered spent?
No
(If yes, please give brief details)

Is there any reason why you would not legally be allowed to work in the UK?
No

Driving Skills:

If you are interested in being a volunteer DRIVER, please complete the following:

Do you have a clean driving license? No

How many years driving experience do you have? _______

Have you had any driving convictions/disqualifications in

the past 10 years? Yes/No
the past 5 years? Yes/No

Do you have any experience of driving a transit-sized van? No

Are you experienced in driving in cities? No

Experience and Interests.
This is the part where we get to know a little bit about you! Please give an outline of any
previous and/or current work experience including any voluntary work and other areas that
may interest you. Also why you are interested in volunteering with us.

I volunteer a couple of times a week at Feed Bristol, which helps people to access the
natural world through learning how to grow food. As well as growing food I am
interested in how to reduce food waste and poverty in the city, and have
recently been attending Caf Connect in Easton, which cooks meals from
supermarket wasted food.

I volunteered in Kenya for 3 months doing permaculture, reforesting, living with

young orphans, and constructing a house from natural materials (SuperAdobe).

Im also a qualified teacher of the Alexander Technique.

References:

Please give below the names and addresses of two people whom we may contact as
referees. These people should be able to comment on your suitability for volunteering and
can be colleagues, friends, people who know you well but not family members.

Name: Pedro Name: Jon Chubb

Address: 26 Neath Road, Bristol Address:

Post Code: BS5 9AP Post Code:

Tel. No: 07792 230702 Tel. No: 07717 743644

Email address: Email address:

jonathan.chubb@performancein.com
Relationship to you: Housemate Relationship to you: Colleague
For office use only: Reference - check For office use only: Reference - check

Finally

How did you hear about volunteering with FareShare?

Through Pedro and Salim, who volunteer for you, who Im friends and housemates with.
Please sign, date and return your completed application form to FareShare South West by
email or by post (see address below).

Thank you.

Signed: Tom Yates

Date: 16th May 2017

FareShare South West

Unit 4
Little Ann Street
St Judes
Bristol BS2 9EB
FARESHARES EQUAL OPPORTUNITIES MONITORING FORM

This monitoring form does not constitute any part of the short-listing or interview process.
If you choose not to complete this section, your application will not be affected. The
purpose of this section is purely to gain general information about the composition of the
applicants within FareShare and all details given below will be strictly confidential.

FareShare will monitor its policy and practice to improve its effectiveness. For full details,
please ask to see the Equal Opportunities Policy.

PLEASE TICK APPROPRIATE BOXES

1. I would describe my ethnicity as:

A) White B) Mixed / C) Asian or D) Black or E) Other ethnic

multiple ethnic Asian British Black British groups
groups
British White and Bangladeshi African Arab
Asian
Eastern White and Chinese Caribbean Iranian
European Black African
Gypsy White and Indian Somali Iraqi
Black
Caribbean
Irish Pakistani Kurdish
Irish or Scottish Turkish
Traveller
Roma
Any other Any other Any other Any other Any
White mixed / Asian Black other ethnic
background multiple background background background
background
Please state Please state
Please state Please state Please state

Prefer not to
answer

If not listed above please provide details below:

2. Sex (Please tick):

Female Male Prefer not to answer

3. Gender reassignment (please tick):

Is your gender identity different from the gender you were assigned at birth?
Yes No Prefer not to answer

4. Age (please tick):

Under 18 40 50
19 25 51 64
26 39 65 or over Prefer not to answer

5. Sexual Orientation (please tick):

Bisexual Lesbian or Gay
Heterosexual Prefer not to answer

6. Disability (please tick)

Do you consider yourself disabled?

Yes No Prefer not to answer

It helps us to know whether we are reaching all disabled people, please tick the relevant
impairment / disability below (Please tick any that apply):

Deaf BSL user

Hearing impairment
Learning difficulties
Mental Health difficulties
Long term limiting illness
Physical impairment
Speech impairment
Visual impairment
Blind/Partially sighted
Dyslexia
Wheelchair User
Unseen Disability
Personal Care Support
Disability not listed above
Prefer not to answer

Health/Disability/Special Needs:

Please indicate any health issues/special needs which you feel we would need to know
about to ensure your safety as a FareShare volunteer. This information will enable us to act
swiftly in case of an emergency and will not in any way affect your application. If not listed
above please provide brief details:
7. Faith: How would you describe your Religion and/or Belief? (Please tick):

Buddhist Muslim
Christian Sikh
Hindu None
Jewish Dont know / not sure

Other faith, religion or belief (please state) ..

Prefer not to answer

Date: _____________________

For office use:

Form on equal opps database

Thank you for completing this form; it helps us to ensure that we plan and provide fair
and accessible services.

If you would like to discuss this form please contact us on: 0117 9542220 / HYPERLINK
"mailto:info@faresharesouthwest.org.uk" info@faresharesouthwest.org.uk

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