Retail Volunteer application form

I have had an injury or medical condition or disability which:

• May be aggravated by my working at the volunteering job for which I am applying.
• May reduce my ability to carry out efficiently all the duties required of me.

Note: injury or medical condition or disability includes any condition caused by gradual process, accident, disease or infection, such as but not limited to noise induced hearing loss, back problems, musculoskeletal problems, occupational overuse syndrome (repetitive strain injury), alcohol and/or drug addiction/dependence, chemical sensitivity in the form of dermatitis, allergies or respiratory problems.

• I agree to my name and phone number being used within Cranford Hospice
• I understand that I will be required to attend training courses
• The personal information contained in this form will be held by and remain confidential to Cranford Hospice, Under the Privacy Act 1993, you have the right (with certain exceptions) to request access to, and correction of, any personal information held by us.
• I declare that all the information provided by me in support of my application is correct. I acknowledge that if I have provided incorrect or misleading information or have omitted information of significance, I may be disqualified from becoming a volunteer, or if appointed, be liable to be dismissed.

If you have any questions, please contact the Retail Manager: