My organisation would like COVID-19 volunteers

Organisation/Group Name (required)

Address (required)

Postcode (required)

Role Location (if different to above)

Volunteer Coordinator Name (to be used as a point of contact for volunteers)

Email (to be used as a point of contact for volunteers)

Mobile Number (to be used as a point of contact for volunteers)

Landline Number (to be used as a point of contact for volunteers)

Website (or Facebook details if no website)

• Is your group offering help and support for vulnerable people affected by COVID-19 situation? YesNo
  
  If YES please provide brief description including times and location (if different than above).
• DBS check required? YesNo
  
  If yes, Enhanced or Basic? EnhancedBasic
• Drivers/Cyclists Needed? YesNo
• Drivers with use of own car needed? YesNo
• Expenses Paid? YesNo

Volunteer Roles

Please indicate the kind of role(s) you are seeking volunteers for: -

• Street Volunteer Organiser YesNo
• Delivering Essential Supplies YesNo
• Collecting Prescriptions YesNo
• ‘Getting Online’ Digital Support YesNo
• Telephone/Online Parent Home Schooling Support YesNo
• Food Distribution Centres YesNo
• Dog Walking YesNo
• Interpreting YesNo
  
  If interpreting please state language required:
• Telephone Helpline YesNo
• Telephone Befriending YesNo
• Leafleting YesNo
• Wellbeing Support to Others YesNo
• Adding capacity to key services (like care homes) in case of staff shortages YesNo

Please provide a full description for EACH of the roles you are recruiting for

• Appropriate for under 18s? YesNo
• Can role be done from home by someone self-isolating due to age/health condition? YesNo

When do you need volunteers?

• Monday MorningAfternoonEvening
• Tuesday MorningAfternoonEvening
• Wednesday MorningAfternoonEvening
• Thursday MorningAfternoonEvening
• Friday MorningAfternoonEvening
• Saturday MorningAfternoonEvening
• Sunday MorningAfternoonEvening

Your data

• Are you happy for us to share your contact details with a volunteer who has registered with us and is interested in the role? YesNo
• I agree that information/data relating to me and my organisation which has been obtained by Community CVS, including the personal data given by me on this form, may be held and processed either on computer or in manual records and may be disclosed to officers and authorised employees of Community CVS and Blackburn with Darwen Borough Council and used by Community CVS or Blackburn with Darwen Borough Council for any purpose relating to community and voluntary support in the borough. YesNo
• I consent to be added to Community CVS mailing list to keep up to date about events and projects. YesNo