Date of Birth *
Preferred Method of Contact (Hold down ctrl to select multiple answers) Home TelephoneMobile TelephoneEmailPost
Please give FULL details of two people we can contact for a reference (not relatives) PLEASE NOTE THIS SECTION IS MANDATORY Title * MrMrsMissMsDr
Full name *
Email address *
Second Reference. Title * MrMrsMissMsDr
Emergency Contact (Please provide contact details of someone we can contact in case of an emergency) Name *
Home telephone *
Mobile telephone *
How did you hear about volunteering opportunities at St Luke’s Hospice Plymouth? ColleagueCollege/school/universityCorporate volunteer dayEx Campbell page volunteerExisting volunteerEx-volunteerFamily member or friendJobcentreLocal knowledgePersonal experiencePLUSSPlymouth GuildSaw an advertSocial mediaSt Luke‘s eventSt Luke’s charity shopSt Luke’s websiteUPSU volunteer centreOther (Please specify)
If Other Please Specify
Why do you want to volunteer for St Luke’s Hospice Plymouth? Be useful/to helpDuke of Edinburgh AwardFormer volunteer/staffGain confidenceGain experienceMaintain/utilise previous skillsMeet new people/socialisePersonal experience with St Luke‘sSpare timeStudent placementSupport local communitySupporter of St Luke’sTo give something backWork experienceOther (Please specify)
Which volunteer role are you interested in? Your first choice of role is:
Which other roles are you interested in? Administration (Turnchapel)Administration (Plympton)Amazon and eBay assistantBefriendingBereavement supportCarers ChampionChaplaincy assistantCommunity fayre co-ordinatorComplementary and alternative medicine practitionerCorporate fundraising administration supportDistribution centre assistant (Plympton)Driftwood Cafe (Turnchapel)DriverEbay and Amazon assistantFinance assistantFundraising assistantGardening (Turnchapel)Lottery volunteerMaintenancePromotions volunteerReception (Turnchapel)Reception (Plympton)Shop assistantSocial careSpecialist unit care volunteerTrusteeWhite Goods (Plympton)
Please specify which shop if retail role BarbicanBarbican Shabby ChicCallingtonCornwall Street (97a)CrownhillDrake City CentreEbringtonElburtonEstoverFurniture Warehouse Shop (Plympton)Higher ComptonHownicknowleIvybridgeKingsbridgeLauncestonMilehouseModburyModbury BookshopPlympton (90 The Ridgeway)Plympton The AtticPlymstockPlymstock BookshopSaltashSt BudeauxStokeSugar MillTavistockTorpointTransit WayWhitleighYealmpton
Availability - Please provide us with further information about your availability. What date are you available from?
Length of time available
Please select all days that you would be available to volunteer * Monday AMMonday PMTuesday AMTuesday PMWednesday AMWednesday PMThursday AMThursday PMFriday AMFriday PMSaturday AMSaturday PMSunday AMSunday PMFlexible
Do you need a work permit to work in the UK? (If you are from the European Union, you are able to volunteer in the UK. For those from outside the EU, you will need to check that your visa allows you to volunteer. We advise that you contact the UK Borders and Immigration Agency for more information. St Luke’s is unable to sponsor volunteer visas.) Please select Yes or No from drop down. YesNo
Rehabilitation of Offenders Act 1974 - Exemption form S4(2) Have you ever been convicted of any offence by a court of law? (This voluntary work is exempt from this and volunteers are not therefore entitled to withhold information about ‘spent’ convictions. In the event of you ever having been convicted of any offence by a court of law, please select Yes below and it is mandatory to supply details of the offence(s) with dates in a separate email to the application to firstname.lastname@example.org.) Please select Yes or No from drop down. YesNo
If you ticked that you do have convictions, please provide further details of your convictions and dates below. Although this is a secure website, we cannot guarantee the safety. If you are not happy to provide the information as part of your online application, please post the details to us as: Strictly Private & Confidential, St Luke’s Hospice Plymouth, Volunteer Services, Stamford Road, Turnchapel, Plymouth, Devon, PL9 9XA We are able to process your application further only once we have received the information.
The manager will ask you to sign the below statement at the start of your volunteering with St Luke’s:
– All matters relating to the internal affairs of St Luke’s Hospice Plymouth must be confidential and on no account should this confidence be betrayed.
– Any departure from the standards of confidentiality will be regarded as gross misconduct, which could lead to immediate dismissal from your voluntary role.
– Information concerning patients must only be given to relatives by a member of the clinical team.
– I agree not to visit patients in their home without the express permission of my Line Manager (excluding befriending, bereavement support and chaplaincy).
– Should the Police or Press request information from you they should be referred to the Chief Executive or the Senior Management Team of St Luke’s Hospice Plymouth.
This is a mandatory requirement for all volunteers at St Luke’s Hospice Plymouth.