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Please read our application information page before completing this form.

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Volunteer Application Form
Section A : Personal Details
Use this email for a DBS Check? »

Section B : Emergency Contact

Please give details of someone you would like us to contact in the event of an emergency

Section C : Character Reference

Please give the name and address of two referees, who have known you for at least two years. They should not be relatives or partners.



Section D: Volunteering

Do you have voluntary service experience?
Size for volunteer polo tops
Size for mens shirts
Size for womens blouses
Please note - Becoming a Trust volunteer automatically enrols you as a Foundation Trust member.
Section F : Health Declaration
Are you in good health
Are you currently being treated by your GP
Do you suffer from Epilepsy
Do you have diabetes?
Have you been immunised against tuberculosis
Have you been immunised against Hepatitis B
Have you been immunised against Rubella
Have you been immunised against Tetanus (up to date)
Have you been immunised against Covid-19? (both vaccinations)

Section G: Rehabilitation of Offenders Act 1974

Have you any information to declare »

Section H : Eligibility to work in the UK

I confirm that I am eligible to work in the UK »

Section I : Monitoring information

Ethnic Origin: White
Ethnic origin: Asian or Asian British
Ethnic orgin: Other
Ethnic Origin: Mixed
Ethnic origin: Black or Black British
Not stated


We aim where possible to provide equal access and equipment to ensure that volunteering is an inclusive activity. If you require any assistance we will try to help.

Do you consider yourself to have a disability
Section J: About you

Section K : Code of Conduct    

Code of Conduct in Respect of Confidentiality for  

Non Contracted Staff including Third Party Organisations


During the course of your time in the Trust, you may acquire or have access to confidential information which must not be disclosed to any other person unless in pursuit of your duties or with specific permission given by a person on behalf of the Trust. This condition applies during your relationship with the Trust and after the relationship ceases.


Confidential information includes all information relating to the Trust, its patients and employees. You may come into contact with this information through handling patient’s records, telephone enquiries about patients or staff, electronic database or methods of communication, use of fax machines, handwritten notes made containing patient information or even seeing a person who is known to you attending for treatment, etc. If you are in doubt as to what information may be disclosed, you should check with your manager.


The Data Protection Act 1998 regulates the use of all personal information and together with the Computer Misuse Act 1990 provides criminal offences relating to unauthorised access to such information. Relevant details of these acts can be found in the Trust Information Security Policy, which is available in the work access or on Trustnet. If you are found to have made unauthorised access to or disclosure of personal information you may face legal action.

I understand the above, and that I am bound by a duty of confidentiality and agree to adhere to this code of conduct and the requirements of the Data Protection Act.

Section L : Confidentiality and data protection


I understand that anything I hear or learn concerning patients, relatives, careers or staff in the course of my duties as a volunteer within the East Kent Hospitals University NHS Foundation Trust must be treated in the strictest confidence, and I agree to the code of conduct under the Data Protection Act 1999
I agree to be registered as a Volunteer and to abide by the guidelines concerning the duties of volunteers contained in the Volunteer Services policy.
I declare that the information given on this form is true and complete to the best of my knowledge and belief.
I understand that any information given by me will be treated as confidential and only be used in relation to my voluntary work.
I agree for my information being used to enrol me as a foundation trust member. I understand that information used for this purpose will not be shared without my consent with third parties.
Please contact the team by email ekh-tr.volunteers@nhs.net  for more details. We will be in contact with you to arrange an interview. 
Please ensure you have completed ALL the required fields (marked with ») or your form will not be submitted.