Volunteer Registration

Volunteers will be covered by North Lincolnshire Councils Insurance Policy. The following information is required for insurance purposes and helping us to match potential volunteers to the most appropriate tasks.

Name

Title
If Other, please specify
First name(s) *
Surname *

Date of birth *	Date of birth Month Day Year

Address

If the address is within North Lincolnshire, enter the post code in the box below and then select "Find Address". If the address is outside of North Lincolnshire, or your address is NOT SHOWN in the list or is incorrect, you will need to enter the the address in the boxes provided below.

Post Code *


Prefix e.g. first floor flat.
House Number/Name *
Street *
Town/Village
County
Country

Contact details

Telephone number *
Mobile telephone number

E-mail address

Other Information

Tetanus Jabs up to date

Yes

Do you have any medical condition or allergy that you consider may affect your voluntary activity (please include any details of any treatment by a doctor or hospital visit within the last 2 years)

Health Declaration

I understand that being a volunteer may be physically demanding. I consider myself to undertake the tasks I have expressed an interest in and agree to inform North Lincolnshire Council of any changes to my health.

I Agree

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