Join the Community Exchange

As a group

Your Details

First Name *

Last Name *

Telephone Number *

Email *

Address

Address Line 1 *

Address Line 2

Town/City *

County *

Postcode *

Your needs and how you can help

Please tick the appropriate boxes to indicate the skills / assistance you are willing to offer to Community Exchange members and the areas that you would like assistance with.

I need help with

I can give help with

Monitoring Information

Date of Birth *

Gender *

Employment Status *

Ethnicity *

Disability Status

Reasons for volunteering *

References

For safeguarding purposes we will ask for 2 references from you if you wish to carry out any activities that involve direct contact with individuals. If you are only going to carry out roles that do not involve direct contact with others then there is no need to provide reference details. This can be changed at a later date.

Both referees will receive an email to provide their reference. Your referees should not be a family member and they should have known you for at least 2 years.

Reference 1

Name

Telephone Number

Reference 2

Name

Telephone Number

Choose a password

Password *

Confirm Password *

I have read and agree to the rules (read rules) and Terms & Conditions (read terms and conditions) of the Community Exchange

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