Volunteer Application

Your Details

First Name

Last Name

Street Address

Street Address Line 2

Street Address Line 3

City

Postcode

Country AndorraUnited Arab EmiratesAfghanistanAntigua and BarbudaAnguillaAlbaniaArmeniaAngolaAntarcticaArgentinaAmerican SamoaAustriaAustraliaArubaÅland IslandsAzerbaijanBosnia and HerzegovinaBarbadosBangladeshBelgiumBurkina FasoBulgariaBahrainBurundiBeninSaint BarthélemyBermudaBrunei DarussalamBoliviaBonaire, Saint Eustatius and SabaBrazilBahamasBhutanBouvet IslandBotswanaBelarusBelizeCanadaCocos (Keeling) IslandsCongo, The Democratic Republic of theCentral African RepublicCongo, Republic of theSwitzerlandCôte d’IvoireCook IslandsChileCameroonChinaColombiaCosta RicaSerbia and MontenegroCubaCape VerdeCuraçaoChristmas IslandCyprusCzech RepublicGermanyDjiboutiDenmarkDominicaDominican RepublicAlgeriaEcuadorEstoniaEgyptWestern SaharaEritreaSpainEthiopiaFinlandFijiFalkland Islands (Malvinas)Micronesia, Federated States ofFaroe IslandsFranceGabonUnited KingdomGrenadaGeorgiaFrench GuianaGuernseyGhanaGibraltarGreenlandGambiaGuineaGuadeloupeEquatorial GuineaGreeceSouth Georgia and the South Sandwich IslandsGuatemalaGuamGuinea-BissauGuyanaHong KongHeard Island and McDonald IslandsHondurasCroatiaHaitiHungaryIndonesiaIrelandIsraelIsle of ManIndiaBritish Indian Ocean TerritoryIraqIran, Islamic Republic ofIcelandItalyJerseyJamaicaJordanJapanKenyaKyrgyzstanCambodiaKiribatiComorosSaint Kitts and NevisKorea, Democratic People's Republic ofKorea, Republic ofKuwaitCayman IslandsKazakhstanLao People's Democratic RepublicLebanonSaint LuciaLiechtensteinSri LankaLiberiaLesothoLithuaniaLuxembourgLatviaLibyaMoroccoMonacoMoldovaMontenegroSaint Martin (French part)MadagascarMarshall IslandsNorth MacedoniaMaliMyanmarMongoliaMacaoNorthern Mariana IslandsMartiniqueMauritaniaMontserratMaltaMauritiusMaldivesMalawiMexicoMalaysiaMozambiqueNamibiaNew CaledoniaNigerNorfolk IslandNigeriaNicaraguaNetherlandsNorwayNepalNauruNiueNew ZealandOmanPanamaPeruFrench PolynesiaPapua New GuineaPhilippinesPakistanPolandSaint Pierre and MiquelonPitcairnPuerto RicoPalestine, State ofPortugalPalauParaguayQatarReunionRomaniaSerbiaRussian FederationRwandaSaudi ArabiaSolomon IslandsSeychellesSudanSwedenSingaporeSaint HelenaSloveniaSvalbard and Jan MayenSlovakiaSierra LeoneSan MarinoSenegalSomaliaSurinameSouth SudanSao Tome and PrincipeEl SalvadorSint Maarten (Dutch Part)Syrian Arab RepublicEswatiniTurks and Caicos IslandsChadFrench Southern TerritoriesTogoThailandTajikistanTokelauTimor-LesteTurkmenistanTunisiaTongaTurkeyTrinidad and TobagoTuvaluTaiwanTanzania, United Republic ofUkraineUgandaUnited States Minor Outlying IslandsUnited StatesUruguayUzbekistanHoly See (Vatican City State)Saint Vincent and the GrenadinesVenezuelaVirgin Islands, BritishVirgin Islands, U.S.Viet NamVanuatuWallis and FutunaSamoaKosovoYemenMayotteSouth AfricaZambiaZimbabwe

Email

Phone Number

Date of Birth

Volunteer Application

Please tell us why you are interested in volunteering with MAECare

Tell us about any interests or skills you have that might support your volunteering and support MAECare eg, language skills, craft skills etc

Please give a summary of relevant paid employment and/or voluntary work

How often could you volunteer? - Select -Once a weekTwo or three times a weekOnce a fortnightOnce a month

What kind of volunteering would you like to do?

Admin help

Phone befriender

Tech Tutor

Friendly Visitor

Delivering newsletters

Volunteer Driver

Small group activity support

What days and times are you available?

First Reference (Name, address and telephone)

Second Reference (Name, address and telephone)

Criminal Convictions

Yes

No

Details of Criminal Convictions

How did you hear about MAECare?

Date Application Submitted

I declare that the details given on this form are true and that I have not withheld any information which may bar me from working with vulnerable adults.