Please read our application information page before completing this form.
» Indicates required fields
Section B : Emergency Contact
Please give details of someone you would like us to contact in the event of an emergency
Section C : Character Reference
Please give the name and address of a reference, who have known you for at least two years. They should not be relatives or partners.
Section D: Volunteering
Section G: Rehabilitation of Offenders Act 1974
Section H : Eligibility to work in the UK
Section I : Monitoring information
We aim where possible to provide equal access and equipment to ensure that volunteering is an inclusive activity. If you require any assistance we will try to help.
Section K : Code of Conduct
Non Contracted Staff including Third Party Organisations
During the course of your time in the Trust, you may acquire or have access to confidential information which must not be disclosed to any other person unless in pursuit of your duties or with specific permission given by a person on behalf of the Trust. This condition applies during your relationship with the Trust and after the relationship ceases.
Confidential information includes all information relating to the Trust, its patients and employees. You may come into contact with this information through handling patient’s records, telephone enquiries about patients or staff, electronic database or methods of communication, use of fax machines, handwritten notes made containing patient information or even seeing a person who is known to you attending for treatment, etc. If you are in doubt as to what information may be disclosed, you should check with your manager.
The Data Protection Act 1998 regulates the use of all personal information and together with the Computer Misuse Act 1990 provides criminal offences relating to unauthorised access to such information. Relevant details of these acts can be found in the Trust Information Security Policy, which is available in the work access or on Trustnet. If you are found to have made unauthorised access to or disclosure of personal information you may face legal action.
Section L : Confidentiality and data protection