PEAKS AND DALES ADVOCACY
16 Eagle Parade, Buxton,
Derbyshire SK17 6EQ
Tel: 01298 79539 Fax:01298 70713 e-mail : padaf@btconnect.com
Web site www.peaksanddalesadvocacy.org.uk
A Company Limited by Guarantee Reg. No. 4772008 Reg. Charity No. 1108884
MANAGER - PETER DAWSON. ADMINISTRATOR - SHEILA G
HOLGATE
VOLUNTEER ADVOCATES-APPLICATION
Thank you for your
interest in the advocacy project. Please complete this form as fully as you can-print it off and send to the address above.
If there is anything unclear please let us know. (please enclose two passport
size photographs)
Your full name
.
Address
. Post Code
. Tel
Date of
birth
Brief reasons for wishing to become an advocate:
.
Hobbies and
interests
..
Availability
.
How did you hear about
PADA?
.
Do you have your own
transport?
Which geographic area could you cover ?
.
Referees: Please give the name and addresses of 2 people we can approach for
references. These should be people other than your immediate family.
Referee
Name(1)
........................................
Referee
Name(2)
...................................................
Address(1)
.................................................................................................................................................................
Address(2)
..
Telephone number(1)
Telephone number(2)
Length of time
known(1)............................................................................................................
Length of time
known(2)............................................................................................................
Brief details of your present or previous employment:
......................................................................................................................................................
Because
of the nature of the voluntary work you are interested in, this `post` is exempt
from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974
(Exemptions) Order 1975. Applicants, therefore, are not entitled to withhold
information about convictions which for other purposes are `spent` under the
provision of the Act. Any information given will be completely confidential and
will be considered only in relation to any applications for which this Order
applies.
Have you had any convictions? Please state yes or no:
(If `yes` please give details on a separate sheet which will be confidential to
the co-ordinators)
Declaration:
The above information is correct to the best of my knowledge.
Signature
Date
..