Volunteer Record Card Launch Text To Speech Please enable JavaScript in your browser to complete this form.Personal DetailsLegal Name: *Preferred Name: *Date of Birth:Protected CharacteristicsWe invite you to answer these questions – if you feel able to – which will support us in meeting our obligations under the Equalities Act 2010. This information will be identifiable only to your line manager and appropriate members of the management team. It will not be shared with a third party unless it is anonymised and shared for statistical purposes.How do you describe your ethnicity?How do you describe your gender?What pronouns would you prefer us to use for you? *What is your legal gender as classified at birth?How do you describe your sexuality?Do you identify as being neurodivergent?If so, do you have a official diagnosis?Contact DetailsAddress:Address Line 1CityState / Province / RegionPostal CodeTelephone Number: *Email: *Emergency ContactEmergency Contact Name:Relationship:Address:Address Line 1CityState / Province / RegionPostal CodeTelephone Number:Email Address:Medical DetailsDo you have any known or past illnesses we need to know about?e.g. Diabetes, EpilepsyDo any of these have a long term impact on your day-to-day life?Do you need any additional accommodations with any of these impacts?Known Medical Allergies:e.g. Allergic to PenicillinDo you have any medical devices you may need access to?Inhaler, epi penSubmit Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to email a link to a friend (Opens in new window)Click to print (Opens in new window)MoreClick to share on Pinterest (Opens in new window)Click to share on Pocket (Opens in new window)Click to share on Reddit (Opens in new window)Like this:Like Loading...