	Lydney Playgroup and Nursery Within the grounds of Lydney C. of E. Community School, Bream Road, Lydney, Gloucestershire, GL15 5JH. Telephone Number 01594 841779 Registered Charity Number: 1

Should you have any questions, please get in touch through the Contact Us link

Electronic Application Form Please complete the following questions; alternatively, you can print off the form and post it to the address at the top of this web page.
Title	(Mr / Mrs / etc)
First name
Surname
Address


Town / City
Postcode (in 4 sections)	e.g. PA \| 7 \| 5 \| LT
Telephone (in 2 sections)	e.g. 01505 \| 123456 e.g. 0141-123 \| 4567
Mobile telephone (in 2 sections)	e.g. 09999 \| 123456
How long at this address?
e-mail
N I Number
Full driving licence?	"Y" / "N"
Please tell us why you wish to be a volunteer with the Accord Hospice.
Please tell us what skills and qualities you feel you can bring.
Do you have any area of special interest (e.g. mental health, drugs and alcohol, young people, women’s issues etc).
Experience and/or Employment (Any experience or employment you feel may be relevant, but don't worry if you can’t think of anything).
Education and Training (Please provide details of any education or training courses or qualifications - dates and College details.
At what times will you be available for volunteer work? (Flexible / prefer weekends / prefer daytime / prefer evenings). Give any other details you think relevant.
Where did you first learn about us?
References - please detail 2 referees who can comment on your suitability for volunteering.
1 - Name Position Address Telephone
2 - Name Position Address Telephone
Disclosure. (If you have been convicted of any offence which is not considered “spent” please give details. Volunteers work with vulnerable people and will therefore be Police Checked.)



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