1 VOLUNTEER APPLICATION FORM
Please return to: Sally-Ann Burley, National Coal Mining Museum for England, New Road, Overton, Wakefield, West Yorkshire, WF4 4RH or email to Sallyann.burley@ncm.org.uk Please continue on additional sheets if required.
YOUR DETAILS Title:
_____________________________________
Surname:
_____________________________________
First Name/s:
_____________________________________
Home address Inc post code
_____________________________________ _____________________________________ _____________________________________
Home Telephone
_____________________________________
Mobile telephone
_____________________________________
Email address
_____________________________________
VOLUNTEER OPPORTUNITY Role Applied For:
_____________________________________
How did you find out about this role?
_____________________________________ _____________________________________
Have you any previous _____________________________________ volunteering experience, or are you currently _____________________________________ working as a volunteer? _____________________________________ _____________________________________
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EMPLOYMENT DETAILS Are you at present: Full-time student
Part-time student
Employed
Unemployed
Retired
Current or most recent employment: Dates:
_____________________________________
Company Name and Address
_____________________________________ _____________________________________ _____________________________________
Job Title:
_____________________________________
Description of duties:
_____________________________________ _____________________________________ _____________________________________
EDUCATION Current or most recent education Date:
_____________________________________
Establishment:
_____________________________________
Study undertaken:
_____________________________________ _____________________________________
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RELEVANT SKILLS Please give details of any skills you feel may be relevant to your application (previous work or volunteer experience, training etc)
_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________
Do you have any mining history knowledge
_____________________________________ _____________________________________ _____________________________________
Have you experience of using a computer?
_____________________________________ _____________________________________ _____________________________________
INTERESTS What are your main leisure interests?
_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________
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4 REFEREES We require two referees for all applicants for volunteer opportunities. Please give the names and addresses of two referees (not related to you). 1. Name:
_____________________________________
Address:
_____________________________________ _____________________________________
Telephone Number:
_____________________________________
In what capacity do they know you?
_____________________________________ _____________________________________
May we approach this referee now?
Yes
No
2. Name:
_____________________________________
Address:
_____________________________________ _____________________________________
Telephone Number:
_____________________________________
In what capacity do they know you?
_____________________________________ _____________________________________
May we approach this referee now?
Yes
No
DECLARATION I declare that the information I have given is true to the best of my knowledge. Signed:
_____________________________________
Date:
_____________________________________
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