Revive Returning Volunteer Application Form 2015 Team Leaders: This form is ONLY suitable for volunteers who volunteered at Revive 2013 or Revive 2014, and who you have had regular contact with over the past year, and know very well. If you have any concerns about a team member, Attach photo here or their suitability since last year they should fill in a full application form. This Alternatively you can information is confidential to the Revive team. email a photo to [email protected] Personal Details Title: Name: Surname: ….. Address ……… If you emailed one last year we will still have it so no need to send us one ……… Telephone: Gender: Postcode ………. Mobile: …………………………………… Date of birth: Email Address: ………… Dependents on site with you: …. …. Please give names and dates of births Team (See volunteer information leaflet for more details) Teams for which you want to apply: First choice: Second choice Church leader reference Name: Email: Phone: Further Information Have you had any changes in your health since last year that may affect your ability to work? …. …. …….. Have you experienced any nervous, mental or emotional health problems since last year? …. …. …. Do you have any police enquiries or case of prosecution pending? Have you been charged with any criminal offence since you applied in 2013 or 2014? If yes, please tick If you have ticked, a senior leader in Ichthus will contact you in strict confidence to discuss this. Under the Rehabilitation of Offenders Act 1974, you are not required to disclose any conviction that has become spent, unless you intend to work with children. Volunteer Meals For volunteers and immediate family (i.e. husband, wife or children) only. The first adult will receive a subsidised rate of £100, and teenagers (13-17) will receive a subsidised rate of £100. Otherwise the cost of adult food for the full week is £120. This includes a sit-down breakfast and dinner. Lunch will be provided in the food court. Volunteers: …. Family (adults, 18+): £0 each Family (13-17)…….. Family (5–12yrs): £120 each Total requiring volunteers meals: £100 each Family (0-4yrs): £50 each Total volunteers meal cost: (If unsure leave blank and we will do the calculation for you) Please turn over for important declaration and signature Free Declaration ‘I wish to apply to volunteer at Revive 2015 and confirm that I have read and fully understand the duties of the team I have applied for. I hereby declare that the information I have given is to the best of my knowledge current, true and accurate, and that I am fit and able to fulfill the duties for the team for which I am applying. I am happy for Ichthus Christian Fellowship to obtain references from the people I have named above. I declare that I have no criminal convictions that would affect my suitability to work with children. I give Ichthus permission to request a DBS check.’ Ichthus will request a DBS Enhanced Disclosure for all volunteers applying to work with children, or young adults. As a trust, we undertake to meet the requirements of the Data Protection Act 1998, the Protection of Children Act 1999, the Criminal Justice and Court Services Act 2000 and all other relevant legislation. Signed: ……… Date: ! Your details are stored on a database for administration purposes. We may send you information, by email or other means, of other activities organised by Ichthus Christian Fellowship. Tick here if you do not wish to receive this information. ……. Return to: Revive Volunteers Ichthus Christian Fellowship 7 Greenwich Quay Clarence Road LONDON SE8 3EY
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