Request to volunteer with us

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Volunteer Application form

Personal Details

Volunteer Role

Please identify which aspect of our work interests you.

If you have already spoken with a KCI staff member and have a specific role in mind, please state the role and staff member’s name above.
We aim to place volunteers within a 15mile radius of their home address where possible. Please note that certain volunteering roles may not be available in all locations and may require you to attend the Komuge office.
How will you get to your assignment
Please indicate Place of study, Subjects Studied, Qualifications, Grade and Year

Present or Most Recent Volunteer Placement (optional)

Dates of Volunteering

References

First Referee

Second Referee

If yes, please provide details on a separate sheet, in an envelope marked “Private and Confidential” for the attention of the Programs Manager and attach to this form. All information will be treated in the strictest confidence. Some of our volunteers work closely with vulnerable children/adults; therefore, applicants for volunteer roles will need to sign our Child and Youth Safeguarding policy.

Declarations

Please note that should any information provided on this application form be found to be false, or should there by any wilful omission or suppression of information directly relevant to the role, this may lead to the withdrawal of the offer of volunteering or the subsequent termination of your volunteering placement.

I declare that, to the best of my knowledge and belief, the information provided is correct.

Upload your Signature here: Electronic signature/written signature are both accepted.