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Please complete the application form below to apply for a volunteer role at Listening Ears. Ensure you can set at least 15 minutes aside to complete the form. You should also have details for your references in hand and contact your referees as soon to possible to let them know they will be contacted by Listening Ears.

Voluntary position applied for:	Select Drop in center Admin Events Projects Don't mind
Title:	Select Miss Mrs Ms Mr
Full Name:
Date of birth:
Address:
Address line 2:
Address line 3:
Post Code:
Daytime telephone:
Evening telephone:
Email address:
Language(s) spoken:
Professional or educational background:
Have you carried out voluntary work before?	Select No Yes
If yes please give details:
Why are you interested in this particular role?
What skills and interests do you have that may be useful in your voluntary role?
Your availability:
Do you have any health problems, disabilities or other needs?	Select Yes No
If yes please give details:
Do you have a criminal record?	Select Yes No
Details if yes:
Any other information you wish to add:
How did you hear about Listening Ears? (Don't just write Internet or Magazine, please specify)
References Please give details here of two people who are not relatives or people who you live with. One reference should be from someone in a professional capacity e.g. previous employer, teacher, supervisor, etc. Your second reference should be a character reference from someone that has known you for more than 1 year.
Please give the name and contact details of your first referee
Referee Name:
Relationship to you:
Address Line 1:
Address Line 2:
Address Line 3:
Post code:
Email:
Home/Work telephone:
Mobile:
Please give the name and contact details of your second referee
Referee Name:
Relationship to you:
Address Line 1:
Address Line 2:
Address Line 3:
Post code:
Email:
Home/Work telephone:
Mobile:
Declaration Before agreeing to the declaration please read the following: Listening Ears welcomes applications from diverse candidates in order to promote equality of opportunity for all with the right mix of talent, skills and potential. Criminal records will be taken into account for recruitment purposes only when the conviction is relevant. Unless the nature of the work demands it, you will not be asked to disclose convictions which are ‘spent’ under the Rehabilitation of Offenders Act 1974. Having an unspent conviction will not necessarily bar you from employment.  This will depend on the circumstances and background to your offence(s). I can confirm to best of my knowledge the information given on this form is true and accurate and that I have not omitted any facts, which may have a bearing on my application. If you select disagree, Listening Ears will not process your application.
Declaration:	Select I agree I disagree

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Company Limited by Guarantee. Registration Number 6227466 (Registered in the United Kingdom)
Registered UK Charity. Charity Registration Number 1145028

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