Volunteer Application Form

Personal Information

Have you a medical condition which may affect your ability to help? *


Is this Employment:
Please indicate whether these would be
Have you had any experience that you consider relevant? *

Driving & Vehicle Information

Do you hold a current driving license? *
Do you own or have regular access to a car? *

Please indicate which area(s) you're interested in


We require two references from people (not relatives) who know you well and can comment on your character and suitability for voluntary work.

Please obtain their consent in advance of our enquiry.

Referee 1

Referee 2

Rehabilitation of Offenders Act (Exceptions) Order 1996:

Normally ex-offenders are able to state that, following a period of time which is offence free, they have no criminal record.  The act does not however, make certain exemptions, one of which applies to the work you will be doing.  As this work will involve ‘access to the young, the old, the mentally or physically disabled’, it is our policy, fully in accordance with the Act, to ask you to reveal all offences – including those that in other circumstances would be considered ‘spent’.

Have you ever been found guilty of a criminal offense? *


I wish to be considered as a volunteer.  I declare that the information I have given in this application is correct to the best of my knowledge.  I understand that I could be required to withdraw my services if I have given false information.

Please indicate who we should contact in case you are involved in an accident or emergency

Thank you for submitting your application. East Sussex Vision Support will contact you soon to discuss your application.
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