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Home
About Us
What is Healthwatch
Meet the team
Governance
Our Work
Our Priorities
Our Services
Our Reports
Our Community Insight System
News
News
Newsletters
Events
Events
Get Involved
Volunteer with Us
Become a Community Influencer!
Join the Enter and View team
Join Our Mailing List
Join Our Team
Help with research and surveys
Join the Whipps Cross Community Forum
Information
How to register with a GP
Vaccinations – COVID-19, Flu, MMR, Polio, Mpox and Shingles
Strep A and Scarlet Fever
How to Make a Complaint
NHS Advocacy
Find a Service
How to book a Cervical Screening
What can your NHS dentist do for you?
Primary Care Networks
Integrated Care
Contact Us
Share your experiences
Hoarding workshop
News
About Us
Contact Us
Volunteer Application Form
Personal Information
Title (Mr/Mrs/Miss/Ms/Dr/Other)
Surname
Forename(s)
Previous surname(s) (if any)
Home Address & Postcode
Telephone Number (Home/Mobile)
Email Address
Qualifications
Please list any qualifications you feel are relevant to the role you are applying for: (Please note: There are no essential qualifications for Healthwatch volunteers, having lower qualification levels will not disadvantage you).
Reasons for applying and suitability for becoming a Healthwatch Waltham Forest Volunteer
Please state which role you are applying for
Why do you want to volunteer at Healthwatch Waltham Forest?
Please outline your experience (work, voluntary or other personal/professional experience) and explain how this makes you suitable for the volunteer role you are applying for. Please refer to the role description. Also include any experience working with or representing “hard to reach” or marginalised groups or individuals:
Please give any details of your spare time and recreational interests and activities, or provide any other information you think is missing elsewhere in the application:
Declaration
Please declare any other interests or roles e.g. Councillor of Waltham Forest which may be considered a potential conflict of interest in relation to the role and responsibilities of Healthwatch Waltham Forest:
I have read the role description and volunteer information. If appointed, I will abide by the requirements for good conduct and practice. I will carry out a fair and reasonable amount of volunteer activity on behalf of Healthwatch Waltham Forest. This includes completing any training that may be necessary to help me perform in my role as a volunteer. I declare that the information I have provided is honest, full and accurate and I understand that any failure to declare relevant information or the provision of false information could result in my application being rejected or my volunteer opportunity, should I be successful, being withdrawn. I understand all volunteer appointments will be subject to a satisfactory DBS check if required.
I confirm that all information provided above is true
References
Please give details of two referees who have known you for at least three years. A referee can be a previous employer or could be someone from an organisation you have volunteered with. They could also be a social worker, probation officer, or anyone else who has worked with you and knows you. They may be contacted at a later date about providing a more in-depth reference.
Referee 1
Title (Mr/Mrs/Miss/Ms/Dr/Other)
Surname
Forename(s)
Home Address & Postcode
Telephone Number (Home/Mobile)
Relationship to applicant
Occupation
Email Address
Referee 2
Title (Mr/Mrs/Miss/Ms/Dr/Other)
Surname
Forename(s)
Home Address & Postcode
Telephone Number (Home/Mobile)
Relationship to applicant
Occupation
Email Address
Equality Monitoring Form
Healthwatch Waltham Forest is committed to reaching out to all sections of the community. In order to ensure we are doing this, please complete the form below. The information you give us will remain confidential and used for monitoring purposes only. (This will be detached from your application form and will not be used in the recruitment process).
Date of Birth (dd/mm/yyyy)
Gender
Place and Country of birth
Nationality
Do you live in the borough of Waltham Forest?
Please select
Yes
No
If yes, how long have you lived in the borough
Do you use health or adult social care services in Waltham Forest?
Please select
Yes
No
Do you consider yourself to have a disability?
Please select
Yes
No
Prefer not to say
What is your religion or belief?
Please select
Christianity (all denominations)
Buddhism
Hinduism
Judaism
Sikhism
Islam
Any other religion
None
Prefer not to say
What is your ethnicity?
Please select
White – English / Welsh / Scottish / Northern Irish / British
White – Irish
White – Gypsy or Irish Traveller
White – Any other White background
Mixed / multiple – White and Black Caribbean
Mixed / multiple – White and Black African
Mixed / multiple – White and Asian
Mixed / multiple – Any other mixed / multiple background
Asian / Asian British – Indian
Asian / Asian British – Pakistani
Asian / Asian British – Bangladeshi
Asian/ Asian British – Chinese
Asian / Asian British -Any other Asian background
Black / African / Caribbean / Black British – Caribbean
Black / African / Caribbean / Black British – African
Black / African / Caribbean / British British – Any other Black / African / Caribbean background
Other Ethnic Group – Arab
Other Ethnic Group – Any other ethnic group
Prefer not to say
Data protection statement
The personal data collected will be used for Healthwatch Waltham Forest to record and store contact information for each of our volunteers. This is so we can contact you using the details provided, about your volunteer role. This information consists of both contact and personal details and will be processed by or Healthwatch Waltham Forest staff. All information collected will be entered onto our secure, password protected, cloud based database. A paper copy will also be kept for our records, which will be securely stored by the Volunteer Coordinator. Personal data will be kept for three years after the conclusion of volunteer involvement. The information collected will not be given to other external organisations. By consenting to this privacy notice, you are giving Healthwatch Waltham Forest permission to process your personal data specifically for the purposes identified. You may withdraw your consent at any time by contacting the Volunteer Coordinator at Healthwatch Waltham Forest.
I have read and accepted the privacy notice. I confirm that to the best of my knowledge, the information given on this application is true and correct.
Yes
Thank you for completing the volunteer application form
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Events
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Hoarding workshop
April 10, 2024 @ 11:00 am to 3:00 pm
Connect with others on this informative workshop which looks at what lies behind hoarding tendencies, the impact on mental health and …
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