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Independent Partnership Supporter Application Form

If you are intested in becoming an Independent Partnership Supporter please fill in the application form below and a member of our team will be in touch shortly.
(* Please note all fields marked with a (*) are required fields which must be filled in)

 

First Name:*

 

Surname:*

 

Address:*

 
 
Postcode:*
 
Telephone:*
   
Email:
 
Date of Birth:
   
Ethnic Group:
   
Ability Status:
   
Employment Status:
   
How did you hear about the IPS scheme:
   

You will need access to your own transport to carry out the role of an IPS.

Please tick this box to confirm you have transport

   
Do you have any special requirements e.g. diet, learning difficulties or access that could affect participation in the training programme or your role as an IPS?   
               Yes    No
(It is helpful for us to know to enable us to support you.)
If yes give details:
   

Most of our volunteering takes place during the day, Monday to Friday in term time. When can you generally be available to volunteer following training?
(please tick all the boxes when you are available)

Monday:
 

Tuesday:

  
Wednesday:
Thursday:
Friday:
 
Are there any times when are you not available?
   
Please outline any relevant experience, special interests or skills that might help you carry out the role:
   
List any previous OCN study (please give OCN learner ID):
   
Why do you want to become a volunteer:
   
Are you involved in a local parent group: Yes    No

If yes - which group?

   
Please note below the names and addresses of two people we may contact for a character reference: (not relatives)
1. 2.
   
Do you have a Police Record: Yes No
   

Under the Rehabilitation of Offenders Act 1974 if you have substantial access to people younger than 18, you must declare convictions, even if they are spent. Having a criminal record will not automatically debar you from doing voluntary work.

You will be asked to complete a police clearance form on completion of the programme.


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