Thankyou for choosing fill out an application form.

Please fill in all boxes, and read the notes. If you have any questions or queries, please call the office on 01902 420 296

Name:
House Number:
Street:
Town:
Country:
Post Code:
Telephone:
Mobile:
E-mail:
Date of Birth:
School/Organisation:
Emergency Contact Name:
Relationship to You:
Emergency Contact Number:
Please give details of any medical conditions that may affect your time as a volunteer, and of any medication you are taking:
Ethnicity:

Reference:
Qualifications:
Employment Status:
Where did you hear about KIC/MV?
Why would you like to volunteer?
Do you have a criminal record?
Do you have any dependants?
Have you been an MV before (if so, please give details)

FILLING OUT YOUR VOLUNTEER PLAN

The Volunteer Plan sets out what you hope to achieve, and the purpose of the activity. It is a written statement of your own personal goals and provides a focus to your volunteering.

WHAT I PLAN TO DO

Type here your NAME, the COMPANY you are volunteering with, and what ACTIVITY you are planning to do. Also which AREA you will be doing it in. (ie KIC FM IN SANDWELL) PRODUCING/REPORTING/EDITING/TECHNICAL/PRESENTING/ NEWSREADING/RESEARCH ETC. Also include any other activities you are currently involved in. This can be anything so long as it is voluntary, unpaid, and of benefit to the community. (coaching a sport, running a youth club, helping the homeless etc)

WHAT I HOPE TO ACHIEVE FOR MYSELF

This section should detail your own personal goals. Some suggestions are: Build self confidence Learn/improve technical skills Coaching/managerial skills Experience of being a team leader Meet new people Improve on my communication skills

HOW I PLAN TO BENEFIT OTHERS

By being involved in a radio broadcast that educates the young people and community on subjects such as bullying, drugs, alcohol and crime. Also, I will benefit others by applying the knowledge/skills that I have learned to mentoring others.

WHAT I WILL GIVE

Write here the month you started, the month you plan to finish, and whether you are aiming for 100/200 hours. Also, give an idea of how many hours you are willing to give up each week 5-10hrs/10-15hrs/15-20hrs. This section can be reviewed at any time, and your goals can change.

FINALLY

Sign and date your plan, and get the signature of a member of Staff Now, you can begin to fill in your first timesheet, and remember to log every hour, and keep it up to date. Good Luck!!!!!

What I Plan to Do:
What I Hope to Achieve for Myself
How I plan to Benefit Others
What I Will Give

Information About You

To give you the kind of service you want, the Connexions Service needs to keep some information about you.

Why Do We Keep This Information?

To keep in contact with you;
To make sure you know about our services;
To make sure you get the help, advice and support that meets your needs.

We keep information about you on a secure computerised database.

Your Rights

You have the right to see the information we keep about you. You can:

See your computer record at any reasonable time;
Request a paper copy of your record - we will supply this to you within 40 working days, (there may be a charge for this service);
Ask for your record to be changed if incorrect;
Complain to us if you are unhappy about the way we deal with information about you.

If you want any of this explained to you in more detail, please see a KIC Staff member, or call into your nearest Connexions Centre

The Sort of Information We Keep

First name(s) and Surname
Date of Birth
Address including postcode
Telephone number - at home/mobile
Your e-mail address (if you have one) at school/college/home
Your gender (male/female)
Your ethnicity
School/college/other learning provider/employer
What you are doing at the moment e.g. school, employed, unemployed, etc
Information on your achievements and qualifications

We may share this information with other organisations who are involved with your education, training or support unless you ask us not to.

Other Information

We may also record other information which you have shared with your personal adviser. This is so we can keep a record of what you have discussed. We may also keep a record of assessments you have done with us and any action plans or development plans we have completed with you. It will sometimes be important to share this sort of information with other organisations, to help take forward your plans. We will ask you to fill in a form to give us permission to pass this information on.

If you want to keep information confidential, we will respect this. However, sometimes there may be a legal requirement for us to pass on information without your permission, if for example, there is a risk of serious harm or threat to life. We will do our best to tell you if we have to pass on information.

The policy laid out in this leaflet protects young people as data subjects under the Data Protection Acts 1998

You will be asked to sign this agreement on your first meeting with KicFM

When you are ready to proceed, please click NEXT

Please Note: You will be given a chance to confirm your details on the next page