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Peer Support Volunteer Form

Thank you for your interest in becoming a Peer Support Volunteer.

This form assesses your suitability to help run our online Peer Support Groups. Once we have received this we will contact your references and carry out a DBS check. 
1.Full name(Required.)
2.Home address(Required.)
3.Email address(Required.)
4.Phone number(Required.)
5.Date of birth(Required.)
6.Ethnicity(Required.)
7.What gender do you identify as? Is your gender the same as the sex you were registered at birth?(Required.)
8.What best describes your sexual orientation?(Required.)
9.*Are you a patient/friend/carer/healthcare professional?(Required.)
10.What skills do you have that you feel would be an asset to the role of peer support volunteer?(Required.)
11.Do you have any previous experience of working/volunteering for a charity or running support groups? Please give details.(Required.)
12.Do you attend other support groups? If so, which have you attended?(Required.)
13.Would you be willing to complete Safeguarding Level 1 training (online/e-learning)?(Required.)
14.Would you be happy for us to complete a DBS check?(Required.)
15.Would you be willing to attend meetings with other peer support volunteers to share advice/best practice/offer and receive support?(Required.)
16.How many hours per month can you help?(Required.)
17.What time of day would you generally be available to hold support groups?(Required.)
18.Do you have any additional needs that we should be aware of in order for us to support you in this role?(Required.)
19.Do you have any convictions or conditional cautions which are currently unspent under the Rehabilitation of Offenders Act 1974? [You do not need to disclose anything that is ‘spent’]. (Required.)
20.Is there anything else you would like to tell us? 
21.We would be grateful if you could provide the details for two referees who would be able to provide us with either a job or character reference for you. (Required.)
22.Referee 2(Required.)