Download - UiD - Volunteer Registration Form
Personal Details
Equal Opportunities
Surname:* Title:
Forename/s:*
Home Address:*
Postcode:
NI Number:*
Contact Number:*
Gender:*(please tick)
(please tick)
Disability:
(please tick)
Date of Birth:* DD/MM/YY
(Questions marked * are required)
Female Rathernot say
NoYes Rathernot say
Male
The United Reformed Church39 Convent StreetSwansea - SA1 2BX
Contact: [email protected]
Contact Number:Relationship:
How did you hear about the Unity in Diversity Group?
Volunteer Registration Form
Email:
Are you: community member asylum seeker refugee
Name:Next of Kin
How would you describe yourself?Choose ONE section from A to E, and then tick the appropriate box
Declaration:
When you sign this form you agree that we can share your information with The Big Lottery, which provides money for our activities. We’ll keep your informaton safe in line with the Data Protection Act 1998.
Prefer not to say
BritishEnglishIrishScottishWelshAny other White background, please write in box
Asian or Asian British
Black or Black British
Chinese or other ethnic group
Mixed Heritage
White
White and AsianWhite and Black AfricanWhite and Black CaribbeanAny other Mixed background, please write in box
ChineseAny other, please write in box
AfricanCaribbeanAny other Black background, please write in box
A
B
C
D
E
F
BangladeshiIndianPakistaniAny other Asian background, please write in box
Participant Signature:* Date:* DD/MM/YY
Date:* DD/MM/YYStaff Signature:*
Staff Use Only
