Mental health and wellbeing buddying at the Broomwood CWC

If you are interested in becoming a wellbeing or peer support volunteer at the Broomwood Community Wellbeing Centre fill in the form below. For more information, contact Mike at mike@bluesci.org.uk, or by calling or texting 07445 817485.

Volunteer Form

If you are a human and are seeing this field, please leave it blank.

Fields marked with a * are required

Name *

Date of Birth

Gender

Ethnicity

Address *

Postcode *

Home telephone number

Mobile Number

Please specify your interests

Why do you want to volunteer with us? *

What would you hope to get from the volunteering experience *

We would prefer that you can offer at least two sessions each week. This can be discussed during our first meeting

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Please give a brief description of any paid or voluntary work or studies you have undertaken in the past *

As a first step of this process we require you to disclose any criminal convictions you may have, including those considered 'spent' under the Rehabilitation of Offenders act 1974, or any police action pending. Please be assured that disclosure of a criminal conviction will not necessarily prejudice your application. If you do not have any convictions please write ‘none’ in the space provided

Please provide the names, positions, addresses and telephone numbers for two people whom we may contact as references for you.

First referee

Second referee (if available)

I have carefully read the information I am submitting and declare it to be true. *

Today's date *

Broomwood Wellbeing Centre

If you are interested in becoming a wellbeing or peer support volunteer at the Broomwood Community Wellbeing Centre fill in the form below. For more information, contact Mike at mike@bluesci.org.uk, or by calling or texting 07445 817485.

Volunteer Form