Donation Information

Donor Information

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(Please include the name of your local borough/county)

How many days in the week are you available to volunteer?

(We usually ask for a minimum of one day with at
least three clients)

Which days of the week are you available (Monday-Friday):
How long could you commit yourself to a placement?

(Minimum of one year)

Immigration, Asylum and National Act 2006

Do you require a work permit or any other kind of document to show that you have necessary permission to work/volunteer in the UK?

If yes, please supply your visa number:
If you are currently accessing services for drug and / or alcohol treatment, mental health or ex - offenders, please give details:
Please tell us your reasons for wanting to undertake a counselling placement at peace of mind:
Please tell us what you would bring to the organisation in terms of skills and experience relevant to the placement. As part of this, if you are not sending us in a CV can you please detail your prior work experience, and any relevant training/education.
Please share briefly your therapeutic approach and tools you use in counselling.
Do you have yourself the experience of being in therapy/counselling?
How many counselling session hours have you already conducted?
Are you a member of recognised counselling body such as BACP or UKCP?
References
Please name two referees for whom a reference may be obtained. Where possible this should be a professional person such as an ex-employer, key-worker, college tutor etc; they should have known you for six months or more.
Reference 1
Name:
Position:
Relationship to you:
Organisation (please include address):
Phone number:
Email address:Please ensure you provide an email address for your referee as we will be requesting references via email
Reference 2
Name:
Position:
Relationship to you:
Organisation (please include address):
Phone number:
Email address:
Please ensure you provide an email address for your referee as we will be requesting references via email
Can we contact them at this stage?
Declaration of convictions
As many clients at WDP are vulnerable adults we are exempt from the Rehabilitation of Offenders Act 1974. All convictions, whether spent or unspent, must be declared.
Have you ever been convicted of a criminal offence, received a formal caution, been bound over or received a conditional discharge?
If yes, please give full details, continue on a separate sheet if necessary
Would you be willing to undergo a Disclosure and Barring Service (DBS) check?
  • Please note that you will not be asked to work alone with service - users, unsupervised, until DBS checks have been returned.
  • DBS forms are returned directly to the applicant – you must bring your DBS form to Volunteer Services when you have received it, for copying.
  • Posts will not commence until DBS checks have been returned and copies sent to Volunteer Services.
Declaration
To my knowledge the information above is correct. I understand that if I am appointed and this information is found to be inaccurate this may affect my continued employment with Peace Of Mind