Download bm volunteer application form v1 feb2019 PDF

Titlebm volunteer application form v1 feb2019
File Size472.7 KB
Total Pages8
Document Text Contents
Page 1

Registered in England & WalesRegistered in England & Wales

at 71-75, Shelton Streetat 71-75, Shelton Street

Covent GardenCovent Garden

London,London,

WC2H 9JQWC2H 9JQ

Telephone: +44 749 218 4636Telephone: +44 749 218 4636

Email: [email protected]: [email protected]

Company Number: 11798052Company Number: 11798052

VAT Registration Nr: 1234567VAT Registration Nr: 1234567

44

 Pe Persrsononal al dedetataililss

 Email Address: Email Address:  Date of birth:  Date of birth: **

 DD/MM/YYYY DD/MM/YYYY

 Address: Address:

 Postcode: Postcode:

 Telephone numbe Telephone numbersrs

 Home: Home:

Mobile:Mobile:

* Optional except where a specified age range is required by the role* Optional except where a specified age range is required by the role

applied forapplied for

Page 2

Registered in England & WalesRegistered in England & Wales

at 71-75, Shelton Streetat 71-75, Shelton Street

Covent GardenCovent Garden

London,London,

WC2H 9JQWC2H 9JQ

Telephone: +44 749 218 4636Telephone: +44 749 218 4636

Email: Email: [email protected]@black-major.comm

Company Number: 11798052Company Number: 11798052

VAT Registration Nr: 1234567VAT Registration Nr: 1234567

55

 Emergency contact details Emergency contact details

 Please give details  Please give details of a contact who wof a contact who we should reach in case should reach in case of ane of an
emergency.emergency.

Name: Name: Phone Phone numbersnumbers

 Home: Home:

Mobile:Mobile:

 Health Health

 Do you have any health  Do you have any health conditions or disconditions or disabilities of which we sabilities of which we shouldhould

be be aware? aware? YesYes

 If yes, please give de If yes, please give details: tails: NoNo

☐☐

☐☐

Page 4

Registered in England & WalesRegistered in England & Wales

at 71-75, Shelton Streetat 71-75, Shelton Street

Covent GardenCovent Garden

London,London,

WC2H 9JQWC2H 9JQ

Telephone: +44 749 218 4636Telephone: +44 749 218 4636

Email: Email: [email protected]@black-major.comm

Company Number: 11798052Company Number: 11798052

VAT Registration Nr: 1234567VAT Registration Nr: 1234567

77

 Please tell us wh Please tell us why you would like to volunteer wiy you would like to volunteer with BLACKMAJOR.ORGth BLACKMAJOR.ORG

 FAMILY and BME FAMILY and BMEVoluntears.Voluntears.

 Referees and Supporters Referees and Supporters
 Referee 1 Referee 1  Referee 2 Referee 2

NameName

 Email address Email address

 Telephone Telephone

 Address Address

 Postcode Postcode

 In what capacit In what capacity doesy does

this person know you?this person know you?

 How long have  How long have theythey

 known you? known you?

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