- Bristol Drugs Project

Personal Details
Name
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone

Unpaid Work Experience
We are interested in any unpaid work experience you have that you feel is relevant. Please give dates and explain what skills and/or experience you gained. Remember membership of management committees, local groups, etc. is unpaid work.
Dates

Please list dates
Organisation
Main duties
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Dates

Please list dates
Organisation
Main duties
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Dates

Please list dates
Organisation
Main duties
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Dates

Please list dates
Organisation
Main duties
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Dates

Please list dates
Organisation
Main duties

Other Training or Personal Developments
Please give details of any relevant development activities within the past 5 years.
Training Course or Training Activity
Time Spent
Outcome
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Training Course or Training Activity
Time Spent
Outcome
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Training Course or Training Activity
Time Spent
Outcome

Qualifying Questions
Will you be able to volunteer period of 9 months after completion of training?*
- Yes
- No
Have you been in treatment, prison, on probation or on any substitute prescribing programme within the last 6 months?*
- Yes
- No
What is your understanding of harm reduction?*
How would you respond to someone who was in emotional crisis?*
What do Equal Opportunities mean to you?*

Personal Statement
Please use this space to tell us why you would like to volunteer at BDP, and about the experience, skills and personal qualities you would bring to it and expect to get from it. Remember that we are interested in your whole life experience. Applicants will be short listed on the basis of the relevance of the information given according to the volunteer role description. Please continue on additional sheets if necessary, heading each with your name. (Absolutely no more than 500 words please).
*

Disclosures
Disclosure Of Criminal Offences – Rehabilitation of Offenders Act 1974*
- Yes
- No
Because of the nature of this work, this post is exempt from the Rehabilitation of Offenders Act 1974, as it relates to spent convictions and therefore, we need to know if you have any previous criminal convictions. Failure to disclose them could result in dismissal at a later date. Previous convictions will not necessarily disqualify you from applying for this job with this organisation. In making this decision the interview panel will consider the nature of the offence, how long ago, what age you were when it was committed and any other factors that may be relevant.
If 'yes' please list your convictions here. This information will remain confidential from the interviewing panel.*
Problematic Drug And Alcohol Use*
- Yes
- No
BDP believes that problematic drug/alcohol use by a staff member will have an adverse affect on BDP’s work. Problematic use is defined as use which consistently/repeatedly affects an individual’s behaviour at work or their working relationships. Previous problematic drug/alcohol use will not disqualify you from applying for a job with this organisation and we positively encourage those with past personal experience of drug misuse to apply.

Referees
Please provide the names and addresses of two referees who are in the position of being able to comment on your abilities and competence to volunteer in the post. Referees will only be contacted if you are selected.
First Referee
Name*
Address*
Telephone number*
Email
Relationship to you*
Second Referee
Name*
Address*
Telephone number*
Email
Relationship to you*

Equal Opportunities
BDP is striving to become an equal opportunities employer and service provider. It will be a condition of employment that you will be actively involved in the implementation of our Equalities Policy.
Consent*
I agree
I confirm the information given on this form is accurate and true to the best of my belief. I understand that any incorrect information may lead to my application being disallowed or to my dismissal should I have taken up an appointment.

I am willing for this data to be held and processed by BDP under Data Protection legislation and consent to BDP verifying the information given with relevant third parties.

Example