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Home
About Us
Booking
Passengers
Become a Member
Groups and Organisations
Support Us
Volunteer
Donate
News & Vacancies
Contact Us
Volunteer Application Form
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PERSONAL DETAILS - Just a few questions about you.
Name
*
Mr
Mrs
Miss
Ms
Dr
Prof.
Rev.
Title
First
Last
Address
*
Street Address
Address Line 2
City
County
Postcode
Home Phone
Mobile Phone
*
Email Address
Date of Birth
*
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DRIVING DETAILS - To be completed by any volunteers wanting to drive.
Driving Licence Number
*
Driving Licence valid from
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
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11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
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27
28
29
30
31
Year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Driving Licence valid to
*
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
How many years have you held your driving license?
*
Do you have any endorsements?
*
Yes
No
If yes, please give details,
Do you have any convictions for motor vehicle offences in the last 5 years?
*
Yes
No
If yes, please give details,
Have you ever been refused motor vehicle insurance?
*
Yes
No
If yes, please give details,
Have you as a driver been involved in an accident in the last 5 years?
*
Yes
No
If yes, please give details,
Please give details of any relivent driving experince and/or additional licenses such as HGV PSV.
GENERAL HEATH - Please give details of any health conditions that may affect your ability to drive safely.
Have you ever been diagnosed with any of the following?
Epilepsy
Diabetes
Heart disease
A mental health condition
High blood pressure
Visual disorders
If yes, please give details
Do you have any other health issues that may affect your ability to drive?
REFERENCES – in the interest of some of the groups of people you may be asked to drive for, please supply the name and address of 2 referees who are not closely related to you and are over the age of 18.
Reference 1 - Name
*
Mr
Mrs
Miss
Ms
Dr
Prof.
Rev.
Prefix
First
Last
Address
*
Street Address
Address Line 2
City
County
Postcode
Phone number
*
Section Break
Reference 2 - Name
*
Mr
Mrs
Miss
Ms
Dr
Prof.
Rev.
Prefix
First
Last
Address
*
Street Address
Address Line 2
City
County
Postcode
Phone number
*
DECLARATION. Please read the below declaration carefully and tick the box to confirm that you have read and agree to the below terms and conditions. i) I declare that all the details given on this form are correct to the best of my knowledge. I agree to exercise all duty of care for the safety of the passengers and the security of the vehicle whilst in my care. ii) I understand that it is an offence under the Road Traffic Act to knowingly make a false statement to obtain insurance cover. iii) I undertake to inform the CEO of Community Link of any subsequent illness, conditions or events which might affect my ability to drive or assist in a minibus. iv) I further undertake to report any subsequent refusal of motor insurance or driving convictions. I understand the failure to do so and any false declaration above may render the insurance cover for the vehicle invalid and that I may become responsible for all costs and damages. v) I also undertake to notify the organisation of any accident that occurs whilst I am responsible for any of the organisation vehicles. vi) I understand that all the information given to Community Link will be treated in confidence and that any stored data or information will be covered by the Data Protection Act.
I have read and agree with the above declaration.
*
I Agree
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