THE OPEN DOOR

VOLUNTEER APPLICATION FORM

Name: ________________________ Date of Birth: __________

Address: ______________________________________________

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Postcode: ___________ Home phone: ___________________

Church Connection? Yes/No Which Church? _____________

How did you hear about The Open Door? _____________________

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We are open Monday - Friday and work on a shift system:

9.30am - 12noon; 12noon - 2.30pm; 2.30 - 5pm

Please tell us what times would suit you best. _________________

Would you like to tell us anything about yourself? This might include your hobbies, your interest in becoming a volunteer or previous voluntary work. Continue on the back if you wish.

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Do you have any medical conditions or health problems that we should know about? ______________________________________________________

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Name, address and telephone number of 2 referees:

1. _______________________ 2. _______________________

_______________________ _______________________

_______________________ _______________________

Signature: _______________________ Date: _______________