Dad Matters Volunteer Application Form Dad Matters Volunteer Application Form Step 1 of 7 14% This form is a chance for you to tell us more about you before we arrange to meet you. Please answer the questions as honestly and fully as you can. Please contact us if you need any support or would like to meet us so we can fill in the form with you.About YouName(Required) Gender(Required) Current Address including postcode(Required)Email(Required) Tel Number(Required) Mobile Number(Required) Ethnic Origin(Required) Nationality(Required) Date of Birth(Required) DD slash MM slash YYYY Languages Spoken(Required) How did you hear about Home-Start?(Required) Do you hold a current DBS that has been registered with the update service?(Required) Yes No Do you have any communication needs or a disability or health condition that might need adjustments to be put in place? Please specify if answer yes(Required) Yes No CommentHow much time would you expect to be able to commit to Dad Matters as a volunteer on a regular basis? (minimum 30 mins per month)(Required) Which Volunteer Role would you prefer?(Required) Outreach Group Facilitator Event Facilitator Social Media • Outreach – meeting dads at various venues, speaking to them and distributing resources. • Dad Chat – facilitating our face to face groups for dads in various situations. • Online – monitoring, moderating, developing and contributing to our online support groups. • Events – facilitating dad and baby events in various venues. • Lived Experience – if you have experience of any of the challenges dads face, such as miscarriage or perinatal loss, perinatal mental health issues, supporting a partner through perinatal mental health issues, wellbeing, etc, then we’d love to have you help support our peer support groups. ReferencesPlease provide details of two people (not a relative) who have known you for at least two years who may be contacted to provide us with a reference – please make sure they are happy to provide a reference for you before you give their details. If you have a current or previous employer or volunteer coordinator we would like you to include them as a referee. Referee 1Referee 2Name(Required) Name(Required) Address(Required)Address(Required)Email(Required) Email(Required) Relationship (e.g. Previous Employer)(Required) Relationship (e.g. Previous Employer)(Required) Why would you like to become a Home-Start volunteerTick as many as you like(Required) To use existing skills To get out of the house / escape boredom As a placement for college / university To be in charge of something To build a new skill To help me get a job / for my CV To feel useful To address a specific problem in the community To have fun To make new friends To gain ‘work’ experience To build my self esteem To get recognition Your Skills and ExperienceTell us about any jobs or volunteering you have done. renting/caring experience. Don’t worry if your experience is limited!(Required)Please give information about your parenting or child care experience e.g. are you a parent / step-parent / foster carer or do have experience as a professional? What ages are your children? What have you found enjoyable or challenging about being a parent/caring for children?(Required)Have you any commitments that may affect your volunteering with Home-Start? E.g. part time work, study, caring for relatives etc.(Required)What are your hobbies and leisure interests?(Required)Have you any skills or personal experiences which may be relevant to your work as a volunteer for Home-Start? Please include any details of support you have given to others and what you feel you could offer the families Home-Start supports(Required)Is there any other information you would like to add? Dad Matters volunteers are in a position of trust, visiting families in their own homes and having contact with children and vulnerable adults. Home-Start has a responsibility to ensure that no one becomes a volunteer who would misuse this trust or, because of personal reasons, may not be ready to volunteer with us. Therefore, it is essential that you complete this form. All information provided will be kept confidential.Have you had any contact with Children’s Services / Social Services in connection with children in your care?(Required) Yes No Do you have a disability or health condition that may impact your ability to volunteer?(Required) Yes No Have you ever been dismissed from any paid or voluntary work?(Required) Yes No Have you ever been convicted of or received a caution for any criminal offence?(Required) Yes No Are there any matters outstanding which may lead to a criminal prosecution?(Required) Yes No If you have answered yes to any question above please provide further details below:(Required)A criminal conviction may not necessarily exclude you from becoming a volunteer for Home-Start, however, certain offences are so serious that in the light of the nature of our work, you would normally be unable to volunteer. These can include: offences against a person or children; sex offences; benefit fraud; theft when in a position of trust; offences when weapons were used; supplying drugs; offences involving violence; serious motoring offences involving imprisonment; burglary; arson with intent to endanger life. If a criminal conviction is declared above, the Trustees will assess the details (which are anonymised) to determine whether or not your application can proceed. They shall assess the risk to children, vulnerable adults, families and Home-Start and consider if steps can be taken to minimise the risk. It is acknowledged that if a risk cannot be sensibly and effectively managed, the ex-offender cannot be involved with Home-Start. Failure to reveal information that is directly relevant to the position will lead to you being deemed as unsuitable to volunteer. Guaranteed Interview SchemeAs part of our commitment to inclusion, we offer guaranteed interviews for specific groups of people. To qualify, you’ll need to meet the minimum requirements for the role, and identify with one of the below criteria:I’m a member of the Armed Forces or veteran(Required) Yes No I am currently in care, or have previously been in care(Required) Yes No I consider myself to be disabled or have a long-term health condition(Required) Yes No Demographics Monitoring Form – This section is optionalFor either employment or voluntary positions, completing this form helps us to identify any existing inequalities and where new inequalities may be developing and take action to tackle them. While it is voluntary to tell us about this information, doing so will help us to better understand and address any disparities or differences in experience or outcomes. Your answers will be treated in confidence, and all data disclosed will comply with the General Data Protection Regulations and any related data protection requirements. In completing this, you are giving us permission to collect and store the data anonymously to help us with our improvement plans. That means we will not hold this data on your records but use it to help us find out more about the wider make up of our communities or the people who work for us. Age: Are you: Under 25 25 – 34 35 – 44 45 – 54 55 – 64 65+ Do you have caring responsibilities? No Primary carer of a child/children (under 18) Primary carer of disabled child/children Primary carer of disabled adult (18 and over) Primary carer of older person Secondary carer (another person carries out the main caring role) Prefer not to say Disability: Do you have an impairment, health condition or learning difference that has a substantial or long term (over a year) impact on your ability to carry out day to day activities? (Tick all that apply) No known impairment, health condition or learning difference A long-standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, asthma, or epilepsy A mental health impairment, such as depression, schizophrenia or anxiety disorder A physical impairment or mobility issues, such as difficulty using your arms or using a wheelchair or crutches A learning difficulty Blind or have a visual impairment (uncorrected by glasses or lens) D/deaf or hearing impaired Neuro-diverse e.g. dyslexic, dyspraxia or AD(H)D An impairment, health condition or learning difference that is not listed above (please say): Prefer not to say OtherAre you a British Sign Language user? Yes No Prefer not to say What is your ethnic group? (Choose one option that best describes your ethnic group or background) Indian Pakistani Bangladeshi Chinese Any other Asian background, please describe African Caribbean Any other Black / African / Caribbean background, please describe White and Black Caribbean White and Black African White and Asian Any other Mixed / Multiple ethnic background, please describe Arab Any other ethnic group, please describe English / Welsh / Scottish / Northern Irish / British Irish Gypsy or Irish Traveller Roma Any other White background, please describe Please describe What is your main spoken language? English Urdu Arabic Cantonese Polish Bengali Other ( please say) I do not have a spoken language Other language Religion or belief No religion Christian ( including Church of England, Catholic, Protestant and all other Christian denominations) Buddhist Hindu Jewish Muslim Sikh Any other religion, please describe Prefer not to say Other Religion Sex Male Female Intersex Non-binary Prefer not to say Prefer to self-describe( please say): Self-describe sex Is the gender you identify with the same as your sex registered at birth? Yes No Prefer not to say Sexual orientation. Which of the following options best describes how you think of yourself? Heterosexual or Straight Gay or Lesbian Bisexual Other (please say) Do not know or not sure Undecided Prefer not to say Prefer to self-describe (please say) Other orientation Self-prescribe orientation Dad Matters Volunteer Facilitator Person Specification Becoming a Home-Start/Dad Matters Volunteer is simple and rewarding. We ask that our Dad Matters volunteers: • Are a dad or stepdad • Have a positive attitude to working with people of any gender, family status or sexual identity, or who are from any ethnic origin, culture or religion, or who may have a disability • Demonstrate a sensitive and supportive attitude towards others • Be non-judgemental. • Be clear about their role in confidentiality and when sharing is essential to the well-being of a child • Be committed and reliable • Have good communication skills including an ability to listen and ask questions • Understand the need for supporting dads • Have a warm and open personality • Have time and enthusiasm for supporting dads • Be able to work as part of a team and on your own • Be prepared to keep simple records as requested by the scheme • Understand the need for keeping records confidential and secure • Be prepared to engage in regular support and training sessions as appropriate • Be able to approach dads in relevant environments to promote Dad Matters, ask questions and give out information. (Outreach) • To facilitate Dad Chat groups in maternity and other settings. (Facilitation) • To monitor, moderate and contribute to online discussions and closed groups • To facilitate face to face events, for dads and babies. Consent(Required) Please tick the box to show you have read and understoodI give permission for Home-Start to check the progression of my DBS application using the online tracker. Once it has been issued to me I give Home-Start permission to register the DBS online on my behalf and use the online system to re-check the DBS every 3 years for the duration of my volunteering activity. I understand that when I leave Home-Start my online DBS record will not be accessed by Home-Start. I understand that Home-Start holds my personal information in relation to this application in both hard and electronic copy and that this may be used for monitoring purposes. I agree to this information being held and understand it may be shared with Home-Start UK for Quality Assurance purposes. I know of no reason why I would be unsuitable to be a Home-Start volunteer and will report anything which I feel may affect my work as a volunteer to a representative of the scheme. I understand that I may ask to see my records at any time or withdraw this permission by putting my request in writing to the Scheme Manager.
