Request edit access
CARA: Irish Communities Together through COVID-19 Volunteer Registration Form
Thank you for your offer of support. We would be grateful if you could complete this short volunteer registration form. Once submitted, we will be in touch to advise of next steps.
Go raibh mile maith agat – Thank you very much
Personal Details - Full Name *
Personal Details - Full Address *
Please include house number, street name, City/Region & Post Code
Telephone Number *
Email Address *
Where did you hear about this initiative *
Do you have a current DBS *
What volunteer role are you interested in? *
Please tick all that apply
Give brief details of any current or previous paid / voluntary work or experience: *
Which geographical areas can you cover? *
I will be using a car for volunteering *
If YES - I have a full driving licence, no bans or convictions (excluding SP30 - Speeding Points) *
I can confirm that the car I will be using is registered, insured and taxed; it has a current MOT certificate (if appropriate); and is safe & roadworthy. I also confirm (if appropriate) that I have the owners permission to use it. *
My car insurance covers me while volunteering (Insurers who have signed up to the ABI’s volunteer driving – motor insurance commitment do not charge an extra premium but you many need to notify them – check here for more information - volunteer drivers) *
Please give details of two people who can provide a character reference preferably including contact details - email & telephone
Staying Safe Lone Working Code of Conduct - Please confirm that you have read and understood and agree to adhere to the following "Staying Safe - Lone Working" Code of Conduct. *
Guidance prior to a visit. Ensure you have the correct address that you intend to visit. Keep to your schedule of work, if you are delayed for any reason let your supervisor/volunteer coordinator know. Make sure you have all the emergency phone numbers you may need. Make sure that your emergency contact details are up-to-date. Driving to an appointment Avoid parking in a deserted place or where there is poor lighting. Secure the vehicle when you leave it and ensure that you do not leave belongings on show in the vehicle. Remember to charge and take your mobile phone with you, if you have one. Ensure you fill your car up with fuel before your journey, if you are running low. Keep all valuables in your car out of sight. Protocol during Shopping and Delivery Ensure you have local authority key worker letter with ID. Carry out task where possible as part of your own trip to supermarket to minimise risk. Follow government guidelines on social distancing (2 metres) and wash hands before and after volunteering. Follow the latest advice provided by the NHS: and do not volunteer if you or someone you live with, is unwell. Procedure. 1, Knock on door ( if address is an apartment block/communal entrance, you will be given the service user’s number to let him/her know when you are outside) – if no answer, do not tell anyone else why you are visiting such as a neighbour. 2, Ensure your telephone is within easy reach, 3, Leave shopping at door, 4, Stand two meters away. 5, Wait until the person comes to the door then wave and leave. 6, If you see that the person is clearly unwell or collapsed ring 999, do not approach the person, notify Clodagh / Maura immediately. Do not breach social distancing requirements. If no one answers the door ring Clodagh / Maura
Equality & Diversity Code of Conduct - Please confirm that you have read and understood and agree to adhere to the following "Equality & Diversity" Code of Conduct. *
Equality and Diversity is very important. You should treat people as you would expect to be treated; never behave towards someone in a way that is hostile, offensive or humiliating. You should treat people as individuals; respecting their identity even when it is different to your own and being aware that what a person finds acceptable another may find offensive. You should not make offensive or insulting remarks, or engage in ‘jokes’ or ‘banter’ about people based on their age, disability, sexual orientation, gender, race, religion, trans status, or political beliefs. Where you become aware of behaviour like this you should challenge it by calmly explaining that this behaviour is unwelcome. You should not avoid someone simply because they are different to you. Equally, be respectful of people’s choices and don’t press them to share personal details about their life. If you’re worried that you may have said or done something that made them feel uncomfortable, it’s OK to ask them in a respectful manner if something you did or said upset them. If you are challenged about your behaviour or language you should accept feedback in a positive way. If you feel that the language or behaviour of others is offensive and / or it is upsetting you, you will seek advice or support from your mentor or supervisor to help you decide how you want to deal with the issue. Once you’ve talked things over you might decide that the best way forward is to speak to the person in a quiet place. If you decide to do this, we would support you to stay calm and decide on some steps that will help you explain what is upsetting you and how you want things to change. If you don’t feel things are being resolved speak to Clodagh Dunne. While working in any situation treat people as individuals respecting their identity and dignity even when it is different to your own.
Confidentiality & Data Protection Code of Conduct - Please confirm that you have read and understood and agree to adhere to the following "Confidentiality & Data Protection" Code of Conduct. *
While you’re volunteering you may come into contact with and use confidential information. That information might be about people, such as names and addresses or even information about people's circumstances, families, health and other private matters. We have to make sure individuals and other organisations can trust us, so it’s vital everyone understands what information they can and cannot share. What we’ll do to help you: during your induction we’ll explain to you what information you can and cannot access; we'll give you guidance on what you can and cannot share. What you need to do to help us: If you collect any personal data from someone you should explain what you’re collecting, why your collecting it and what you’ll do with it (we’ll explain in your induction what you need to say in your role); look after any personal details shared with you either verbally or electronically; you'll store it confidentially and not disclose or discuss this with anyone else: ensure no photographs are taken of / with person being supported. Do not send personal data by email or copy personal data to any type of removable media, for example, disk or USB stick. All data transferred must be anonymised. No one should make assumptions about sharing confidential information with others. If you are not sure about what information you’re allowed to share then please talk to Clodagh Dunne or Maura Kennedy. If they are not available, then please take down the query and any details and they will deal with the matter.
Safeguarding Code of Conduct - Please confirm that you have read and understood and agree to adhere to the following "Safeguarding" Code of Conduct. *
Safeguarding is about protecting children, young people and vulnerable adults from abuse or neglect. Everybody has the right to be safe no matter who they are or what their circumstances and we are all responsible for the safety of children, young people and vulnerable adults. We must ensure that we are doing all we can to protect the most vulnerable members of our society. What is a vulnerable or “at risk” person? The law about safeguarding applies to: • Children and young people under the age of 18 years; • An adult of 18 years or more who is in need of support because of their age, disability, mental health needs, drug or alcohol misuse, or other illness; and / or who is, or may be, unable to take care of themselves or protect themselves from harm. What is abuse? Abuse can take many forms, and may be: • A single or a repeated act; • A failure to act; • Intentional, or due to a lack of understanding; • And it may be a crime. There are different types of abuse, such as: • Physical abuse such as being hit, slapped or kicked; and which may include being locked in a room or being inappropriately restrained; • Sexual abuse which involves making someone take part in a sexual activity when they have not, or are unable to, give their consent; • Emotional or psychological abuse which may include being shouted at, ridiculed or bullied, as well as being made to feel frightened or pressured into decisions; • Financial and material abuse which is misusing, withholding or stealing someone’s money or belongings; • Neglect which is failing to provide care that results in or could result in someone being harmed. This may include being left with no food, or not receiving help with health or care needs; • Discriminatory abuse which is ill treatment or harassment based on age, gender, sexuality, disability, race or religious belief; • Domestic abuse is when any of the activities above happen as part of a relationship; • Organisational abuse is when any of the activities above happen in an institution (e.g. a care home), company or organisation; • Modern slavery includes slavery, human trafficking and forced labour and domestic servitude (being forced to work for someone); • Self – neglect means failing to look after oneself so badly that it causes serious problems. What are my duties as a volunteer? Volunteers have two main duties around safeguarding: • Be aware that abuse happens and look out for the signs; • Contact Clodagh or Maura immediately if you see or hear anything that causes you concern. Whatever the circumstances you have a responsibility to act if you have any concerns about abuse - doing nothing is not an option. If you think a crime has been committed or if someone is immediate danger, then you should contact the police. If someone discloses abuse you need to always ensure you: • Take any concerns which are raised with you, or concerns that you may have about what you see or hear, seriously; • If someone tells you something that causes you concern, listen carefully; • Do not ask questions other than to clarify what is being said to you; • Don’t lead someone – use open-ended questions. (Open-ended questions start with words like how, what or where and don’t result in yes or no answers); • Do not make a promise to keep something secret; • Always tell your supervisor as soon as you can; • Do not investigate any concerns yourself; • If there is an immediate risk to the person, tell someone as soon as possible and consider if there is anything you can reasonably do to keep the person safe; • You may need to call the police, or an ambulance, to keep someone safe. Can I make friends with people that use our services? You will be building trust relationships, these are different to friendships and our training will support your identifying boundaries which are there to protect both you and the community member, Clodagh and Maura can support you with any concerns”. Even where someone else may seek to establish social contact (for example through Facebook), as a volunteer you should be aware that this kind of contact could cause problems, especially where the contact involves vulnerable people. When people are vulnerable they can misunderstand relationships and this can lead to confusion or even inappropriate conduct. Volunteers should not give out any personal details including phone numbers or email addresses. If in doubt, please discuss social contact outside your formal volunteering time (with people that you volunteer with or meet through your volunteering) with your supervisor before sharing personal information and / or contact details. Volunteers must not accept offers of accommodation, travel, food, drink, entertainment, hospitality, money or gifts of any kind.
Validation & GDPR *
I confirm that the information set out in this application is, to the best of my knowledge, true and complete. I understand that any false statement may disqualify me from volunteering. I also agree that the application form can be stored and processed in accordance with GDPR guidelines.
Date of Submission
Thanks for taking the time. If you require immediate help or support please submit this form below and contact us on: 0151 237 3987
Never submit passwords through Google Forms.
This form was created inside of Irish Community Care. Report Abuse