Apply to become a volunteer mentor | Mentoring Plus

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Personal details

Title

Mr

Mrs

Miss

Ms

Other

Other

First Name

Last Name

Email Address

Address line 1

Address line 2

Town

County

Postcode

Primary telephone number

Secondary telephone number

Date of birth

Do you require a permit to work in the UK?

Yes

No

Please give details of any restrictions, details of visa type and end date

National Insurance number

Your experience & training

Are you currently...

Employed

Volunteer

Student

Other

Work history - 5 years

Company name

Job title

Start Date

What does your role entail?

Add previous work history

Yes

No

work 2

Company name

Job title

Start Date

What does your role entail?

2Add previous work history

Yes

No

work 3

Company name

Job title

Start Date

What does your role entail?

3Add previous work history

Yes

No

work 4

Company name

Job title

Start Date

What does your role entail?

4Add previous work history

Yes

No

work 5

Company name

Job title

Start Date

What does your role entail?

5Add previous work history

Yes

No

work 6

Company name

Job title

Start Date

What does your role entail?

6Add previous work history

Yes

No

work 7

Company name

Job title

Start Date

What does your role entail?

7Add previous work history

Yes

No

work 8

Company name

Job title

Start Date

What does your role entail?

8Add previous work history

Yes

No

work 9

Company name

Job title

Start Date

What does your role entail?

9Add previous work history

Yes

No

work 10

Company name

Job title

Start Date

What does your role entail?

10Add previous work history

Yes

No

Gap in work history

Please indicate and explain any gaps in employment since first leaving secondary education Include specific dates and be sure to account for all gaps

Relevant Qualifications, Education and Training

Please include any academic, professional or skills related experience including dates

Please include any academic, professional or skills related experience including dates

Any training including professional, vocational or job related

Add More Qualifications, Education and Training

Yes

No

Any training including professional, vocational or job related

Add More Qualifications, Education and Training

Yes

No

Any training including professional, vocational or job related

Add More Qualifications, Education and Training

Yes

No

Any training including professional, vocational or job related

Add More Qualifications, Education and Training

Yes

No

Any training including professional, vocational or job related

Volunteer experience

Organisation name

Start Date

End Date

What does your role entail?

1Add Volunteer Experience

Yes

No

Volunteer experience 2

Organisation name

Start Date

End Date

What does your role entail?

2Add Volunteer Experience

Yes

No

Volunteer experience 3

Organisation name

Start Date

End Date

What does your role entail?

3Add Volunteer Experience

Yes

No

Volunteer experience 4

Organisation name

Start Date

End Date

What does your role entail?

4Add Volunteer Experience

Yes

No

Volunteer experience 5

Organisation name

Start Date

End Date

What does your role entail?

5Add Volunteer Experience

Yes

No

Volunteer experience 6

Organisation name

Start Date

End Date

What does your role entail?

Volunteering

What are the main reasons that you want to be a mentor and how do you feel you will benefit from the experience?

In what ways do you feel you could help a young person having a tough time?

Describe any additional skills, experience & interests that you would be willing to share with a young person you mentor

Are you able to commit to the role for one year?

Yes

No

Are you able to commit to core training (one weekend), ongoing training and review meetings (no more than once a month)?

Yes

No

Can you drive?

Yes

No

Do you have access to a car?

Yes

No

How did you hear about Mentoring Plus Please be specific

References

Ref intro

Please give full details, in the boxes below, of two referees. If possible please include your present or past employer or school or college. We do not accept family members or friends as referees

Reference 1

Reference 1

Name

Address

Position Held

Email address

Contact Telephone No

How are they known to you?

How long have you known them?

Reference 2

Reference 2

Name

Address

Position Held

Email address

Contact Telephone No

How are they known to you?

How long have you known them?

Declaration

Safeguarding

I declare that the information I have given on this form is complete and accurate

I am not barred or disqualified from working with vulnerable groups, children or young people

I am not subject to any sanctions or conditions on my employment imposed by the Independent Safeguarding Authority, Secretary of State or other regulatory body

Data

I understand that you will securely store and process the data included in this application and any other data I and my referees may supply in the course of this application, for the purposes of safer volunteer recruitment

I consent to my data being held and processed by Mentoring Plus within the terms of their Privacy Notice

I give consent to photographs/video of myself being used for Mentoring Plus charitable purposes

General

I understand that to knowingly give false information or to leave out any relevant information could result in the withdrawal of any offer of appointment, or my dismissal at any time in the future, and possible criminal prosecution

Get in touch

Mentoring Plus
Riverside Youth Hub
York Place, London Road
Bath BA1 6AE

T: 01225 429694

E: inspire@mentoringplus.net

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