Membership Application Form – Apply Online

Title Date of Birth
Gender MaleFemale  
Forenames Surname
Address
Address continued Postcode
Telephone Number Email Address
Local Authority Area:
Ethnic Origin BlackWhiteMixedOtherI'd rather not say

Please give details of 2 referees who can vouch for your suitability and trustworthiness:

Referee 1 Referee 2
What is each referee’s link to you (i.e., doctor, previous employer, friend, etc)?
If you have a current CRB/DBS check, please give details:
I understand that should I wish to help children, young persons or vulnerable people and have not undergone a CRB/DBS check, it will usually be necessary to apply for disclosure of any information held. I agree that RSVP West may supply the data I give here to its users in accordance with the Data Protection Act 1998.
If available, please also supply a passport-sized photograph of yourself (13⁄4" deep x 11⁄4" wide). If you don't have a copy you can email, then please post this separately to Regional Coordinator, RSVP, The CREATE Centre, Smeaton Road, Bristol, BS1 6XN with your name printed on the back.
Upload photo

If you are applying to be a driver, please give details about your vehicle, or else continue to the 'Help us to help you' section below.

Do you have a valid licence? YesNo Do you have comprehensive insurance? YesNo
MOT expiry date Date of last service
Do you have any experience of driving a minibus? YesNo

Help us to help you


Please tell us what kind of voluntary activity you are interested in (tick all that apply):
Helping the elderly,frail or houseboundDriving (own car)Helping in SchoolsAdult LiteracyLay Assessor RSVP/Alive! Activity SessionsThe Matthew at Bristol HarboursideOffice / ITKnittingTeam Coordinator
Any other activity not mentioned above: Are you fluent in a second language?
If so, which?
Do you play a musical instrument?
If so, which?
What hobbies, interested and skills do you have that might prove useful?
Do you have any additional comments that might help us or you? How did you hear about RSVP or if you have spoken with anyone from RSVP - whom?

Please ensure that you have confirmed your gender and have ticked the box before the sentence “I understand that should I wish to help children” – this is required for the form to be successfully sent.