The AJR Volunteers' Application Form

Please note: all applicants are subject to the standard DBS (Disclosure & Barring Service) check.
 

Fields marked with * must be completed.
* surname:
* forename(s):
  gender: female:   male:
  mobile phone no:
*evening telephone no:
  address:
* postcode:
  date of birth:
* e-mail address:
  how many hours per month can you spare?:
do you have access to a car?: yes:   no
  are you a member of the AJR: yes:   no
  if not, how did you hear of us?:
  special interests/hobbies/skills?:
do you have any particular preferences?:
 
 Individual Befriending  Specialised Dementia Project
 Hospital Visiting  Regional Groups
 Computer Help Service  
please provide the names of two referees:
  first referee name:
 address:
  postcode
  second referee name:
 address:
  postcode