Culture Volunteer Application Form
Please complete this form to become a volunteer with us. 
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Email *
Full name: 
Your address:
Your Postcode (if you are a student this can be your term time address): 
Home telephone number: 
Your mobile number: 
Your email address: 

Do you consider yourself to have a disability or life limiting illness? 

If appropriate please let us know how this may impact on your ability to carry out some volunteering tasks. We strive to make our Volunteer Team as inclusive as possible and this information will enable us to support you and tailor the role to suit you.

Do you have any allergies? Please let us know what they are if this is applicable to you. Other wise you may write no.
Do you have any dietary requirements? Please let know if this is applicable to you. Otherwise you may write no.
How would you describe your gender? 
Clear selection
What age range do you fit into?
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Do you identify as any of the following? 

(Please tick all that apply)


Name of your emergency contact: 
Your emergency contact telephone number:
Your emergency contacts address: 
How do you know your emergency contact?
I give permission for my photos or videos obtained whilst I am volunteering for Culture Volunteer to be used on social media and other forms of publicity: 
Clear selection
Thank you for taking the time to complete this form. We will be in contact shortly. If you have any message for us please let it below. In the meantime if you need to reach us our email address is: culturevolunteerns@gmail.com 
Thank you. 
Team Culture Volunteer NS 
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