01. Personal Information
Preferred Communication:
—Please choose an option— phone email mobile text
Do you require a work permit to work in the UK?
—Please choose an option— yes no
02. How did you hear about this volunteering opportunity?
03. Skills and experience
Please tell us briefly about the skills, interests and experience you have to support you in this volunteering role:
Please tell us briefly about what you are hoping to achieve from your volunteering experience (e.g. learn a new skill, experience for your CV):
05. Availability
Please tick when you are available
Morning Availability
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Afternoon Availability
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Evening Availability
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
06. Emergency contact details
07. References
Please provide two referees who have known you for more than two years. They should not be a relative. An email will always be used as the quickest and preferred method of contact. Please forewarn that we will be in touch shortly and they should respond quickly.
Reference One:
Reference Two:
08. Equal opportunities
Cheshire Fire & Rescue Service aims to provide equal opportunities & fair treatment for all people and is determined to ensure that no applicant, employee or volunteer receives less favourable treatment on the grounds of sex or marital status, sexual orientation, colour, race, nationality, ethnic or national origins.
Gender & age
I am...
—Please choose an option— male female prefer not to say
Age...
—Please choose an option— 17-24 25-35 36-45 46-55 56-65 66+
Nationality
Are you a UK citizen?
—Please choose an option— yes no
National Insurance Number:
Are you an EU citizen?
—Please choose an option— yes no
If YES, which country?
If NO to all the above, what visa do you hold and when does this expire?
Sexual orientation:
Are you...?
—Please choose an option— heterosexual bisexual gay lesbian other prefer not to say
Other (please provide details):
Religious belief/faith:
Are you...?
—Please choose an option— Christian Buddhist Sikh Hindu Jewish Muslim None Prefer not to say
Disability
Do you consider yourself to be disabled?
—Please choose an option— yes no
Do you have any medical conditions that may affect your volunteering duties? (Dyslexia is included within this):
—Please choose an option— yes no
If Yes, please indicate whether you have any requirements or reasonable adjustments that we need to take account of:
Rehabilitation Of Offenders Act 1974
The role you are applying for is exempt from the provisions of section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (exceptions) order 1975. Applicants are asked to declare if they have any criminal convictions, including spent convictions, cautions or reprimands. In the event of an offer of a volunteer role, any failure to disclose such convictions could result in dismissal or disciplinary action by Cheshire Fire and Rescue Service. Any information given will be completely confidential and will be considered only in relation to an application for positions to which the order applies.
Have you been convicted of any criminal offence?
—Please choose an option— yes no
If yes, please give details of offence, including date and sentence:
Other Information
If you have any personal relationship to any employee of Cheshire Fire and Rescue Service (CFRS), Councillors from Cheshire West and Chester, Warrington, Halton, or Cheshire East, CFRS volunteer or CFRS cadet, please give their name and relationship. This does not prevent a Councillor, employee or volunteer giving a reference. (Any approach to Councillors, other employees, volunteers or cadets to influence a selection decision will disqualify you).
If Councillor:
If Employee or Volunteer?:
Cheshire Fire and Rescue Service is committed to equality of opportunity. All applications will be considered on their merits and selection will be made solely on the basis of the suitability of applicants when assessed against role related criteria.
09. Declaration Form
I declare that the information given in this application is to the best of my knowledge correct. I understand that canvassing, either directly or indirectly, of any councillor or employee of Cheshire Fire and Rescue Service or the giving of false or misleading information may lead to disqualification and if appointed, may lead to dismissal
Furthermore, I understand that the information will only be used for recruitment and selection purposes and that it will only be kept on file by Cheshire Fire and Rescue Service for six months thereafter. However, if I am appointed to the post then the information that it contains will be used to form part of my personal file (except for disclosure information, if applicable, which will only be kept for six years).
If you return this form by online (without signature) print your name in place of your signature and you are deemed to have accepted the above declaration.