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Volunteer Application Form

Thank you for your interest in volunteering with Mary Ann Evans Hospice.

To get started, please fill out our volunteer application form.

Your information will help us match you with the right opportunities.

All sections must be completed for ALL volunteer applications.

Name
Address
Preference
Emergency Contact Details
How did you hear about us?
Do you have any convictions, cautions, reprimands or final warnings that are not “protected” as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)
Because of the nature of the work for which you are applying involves direct contact with people who are receiving a health service, we are obliged to ask you, in connection with this application, to disclose any conviction you may have. Under the conditions of the above order, you are not entitled to withhold information about convictions, which otherwise might be considered “spent”. In the event of voluntary work, failure to disclose such convictions could have a bearing on the work you want to do as a volunteer. Please give details of any convictions you may have, below. This information will be treated as strictly confidential. Do you have any convictions, cautions, reprimands or final warnings that are not “protected” as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)

CONFIDENTIALITY DECLARATION

I understand and accept that if I come into possession of information relating to patients/clients or the personal details of a member of staff then I should regard this information as confidential and not divulge it to anyone who does not have the right to such information.

I understand that if I contravene this requirement my placement will be terminated with immediate effect

Thank you for taking the time to complete this form.

Once you have completed your application form please return to:

Business Support Team, Mary Ann Evans Hospice, Eliot Way, CV10 7QL.

Email to maehenquiries@geh.nhs.uk directly or drop off at the Shop you wish to volunteer at or Mary Ann Evans Hospice.

We will require two-character references from two referees who have known you for at least a year.  References should not be from a family member or anyone you live with.

Please ensure that your nominated referees know that we will contact them for a reference.  Please state below the name and contact details of two referees whom we can contact, with your permission:

Referee One
Address
Referee Two
Address

Volunteer Data Privacy Notice

Mary Ann Evans Hospice is committed to protecting your privacy and ensuring that your personal data is handled in a safe and responsible way. This privacy notice explains how we collect, use, and store your personal data when you apply to volunteer with us.

What data do we collect?

We collect personal data including your name, contact details, emergency contacts, previous volunteer experience, and any other relevant information needed to assess your application.

Why do we collect this data?

Your data is used solely for processing your volunteer application, including verifying your identity, providing you with the necessary training, and complying with legal or safeguarding requirements.

How long will we keep your data?

We will retain your data for as long as you remain a volunteer with us. After your volunteering role ends, we will archive your data for 6 years for safeguarding or legal purposes.

Who will have access to your data?

Your data will only be accessed by those required to view and will not be shared with any third parties without your consent, except for legal or safeguarding reasons.

Your Rights:

As a volunteer, you have the following rights under UK data protection law:

  • Right to Access

You can request a copy of the personal data we hold about you.

  • Right to Rectification

You can ask us to correct any inaccurate or incomplete information.

  • Right to Erasure ("Right to be Forgotten")

You can request deletion of your data in certain circumstances, such as when it's no longer needed or you withdraw consent.

  • Right to Restrict Processing

You can ask us to limit how we use your data, for example, while a correction is being made.

  • Right to Data Portability

You can request your data in a structured, commonly used format to transfer to another organisation.

  • Right to Object

You can object to the processing of your data for certain purposes, such as direct marketing or profiling.

  • Right to Withdraw Consent

Where we rely on your consent to process data, you can withdraw it at any time.

  • Right to Lodge a Complaint

You have the right to complain to the Information Commissioner’s Office (ICO) if you believe your data rights have been violated.

Further information can be found via MAEH Privacy Statement and Policy.

If you have any questions or concerns about how we handle your personal data, please contact maehenquiries@geh.nhs.uk.