Thank you for thinking of volunteering with us at The Butterfly Hospice Trust. We are always looking for new volunteers. We have a variety roles and way in which you can help us to help others.

Shops

Shop Volunteering

Gardening

Gardening Volunteering

Warehouse

Warehouse Volunteering

Fundraising

Reception

Administration

If you feel you could support us in anyway please do fill in the form below or download the printable version of the Volunteer Application Form and send it back to through the post.

Title:
MrMrsMissMsOther
if other

Forename(s)*

Surname*

Address*

Telephone Number*

Email Address*

Do you have any requirements in respect of health or disability of which we need to be aware of, in order to support you during your period of volunteering with us?
YesNo
if yes, please add below.

Have you any previous or present connection with the Butterfly Hospice?
YesNo
if yes, please add below.

Nationality (for monitoring purposes only)

Reason for offering help

Where did you hear about the need for volunteers?

Please state your relevant qualifications / skills

In which area of voluntary work are you interested? (subject to availability or current vacancies)
ShopsFundraisingGardeningReceptionAdministrationWarehouse

Availability – please indicate when you may be regularly available(subject to availability)
Monday AMMonday PMMonday EveningTuesday AMTuesday PMTuesday EveningWednesday AMWednesday PMWednesday EveningThursday AMThursday PMThursday EveningFriday AMFriday PMFriday EveningSaturday AMSaturday PMSaturday EveningSunday AMSunday PMSunday Evening


References


Please provide the names, addresses, email address and a contact number of two people who have consented to provide a reference on your behalf. If you have been employed during the past ten years, one should be your current employer, if now unemployed your most recent past employer.

On receipt of a clear employer’s reference, a commencement date will be decided, but this will be a conditional placement for a period of 1 month while the second reference is received.

PLEASE NOTE: REFEREES SHOULD NOT BE FAMILY MEMBERS

First Referee:

Second Referee:


Criminal Record Check


We are required to check, however, a criminal record will not necessarily be a bar to obtaining voluntary employment.

Do you have any unspent criminal convictions?
YesNo
if yes, please


Declaration


Please read this carefully before signing by ticking the box below.

I confirm that the above information is complete and correct and that any untrue or misleading information will give the Hospice the right to reject my application or to withdraw any voluntary post offered.

I also understand that anything I hear or learn, concerning individual patients or my work in the course of my duty as a Volunteer, must be treated in the strictest confidence

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