Resident Volunteer Form


Volunteering Location


Monday Times Available From Times Available Until
Tuesday Times Available From Times Available Until
Wednesday Times Available From Times Available Until
Thursday Times Available From Times Available Until
Friday Times Available From Times Available Until
Saturday Times Available From Times Available Until
Sunday Times Available From Times Available Until

Rehabilitation Of Offenders Act 1974

Some of our Volunteer roles require the completion of an enhanced DBS check. A member of our team will talk to you about his if it is required.

References for this Volunteering Post

Please give two names of people we can contact for references. These should not be relatives.


Emergency Contacts


Location Role Interest

Please indicate which area you are interested in volunteering in:

Show suggestions for other interests, special skills or hobbies
Craft work: Knitting/Crochet/Corking Appliqué Embroidery/Lace making/Beading/Decoupage/Cross Stitch/Parchment/Papier-mâché/Jewellery making
Wellbeing Activities: Reminiscence/Holistic Therapies/Hand Waxing/Healthy living/Men’s Health Club/ Women’s’ Health Groups
Dance: Salsa/Sequence/Ballroom/Tap/Scottish dancing/Belly dancing/Line Dancing/ Country dancing/other
Sport: Gym/Aerobics/Chairobics/Angling/Darts Canoeing/Swimming/Short Mat Bowls/ League games/Archery/Curling/Snooker

Retail Role Interest

We want to ensure that we find the opportunity that will be most fulfilling for you.
To match your retail interests and/or talents with our activities we need to know what experience you have or what area you would be interested in trying.
Please tick all that apply:

Fashion Antiques/Bric a brac Accessories Music
Books Films Customer Service Toys
Housekeeping Cleaning Display Window Dressing

Disclosure and Barring Service:

Some volunteering opportunities are subject to a satisfactory Disclosure and Barring Service check. Someone will discuss this with you if it is required.

Data Protection

How we use this information: We collect this information from you via our Volunteer Application process to enable us to administer your volunteering activity, keep a record of your relationship with us, to ensure we know how you prefer to be contacted and to understand how we can improve our services and information.

The information which you have disclosed to us will be retained whilst you remain a volunteer of ExtraCare. However, some of the information provided will need to be retained for statutory purposes after this period. You have the right to see any information that we hold about you in a retrieval system such as a computer database or paper index system with appropriate notice. At no time will we provide or sell any of your details to a third party without your permission. We may compile statistical data on our volunteers from time to time but this will never include references to a particular individual.

By Submitting the form you are agreeing with ExtraCare receiving your details.