Apply for a volunteering opportunity: COVID-19

Personal details
First name
Last name
Age
Phone number (no spaces)
Email address (we'll send a confirmation email to this address)
Emergency contact details
Emergency contact's name
Emergency contact's phone number
Your address

Please enter a Denbighshire postcode and then click the 'Find address' button.
If you live outside of Denbighshire, or if your address doesn't come up, you can type your address in the boxes.
Postcode
Address line 1
Address line 2
Address line 3
Address line 4
Address line 5

Disclosure and Barring Service (DBS) certificate
Do you have a current Disclosure and Barring Service (DBS) certificate (within the last 3 years)?
YesNo

Disclosure and Barring Service (DBS) certificate details
Which workforce does the Disclosure and Barring Service (DBS) certificate cover?
Adult workforceChildren workforce
Have you subscribed to the DBS Update Service?
YesNo

Driving licence
Are you able to drive?
YesNo

Driving licence details
Please select which type of licence you have:
Category B (Car)Automatic (Car)
Do you have access to your own vehicle?
YesNo
Does your insurance cover business use?
YesNo

Last / current employer

Please note we will need to approach them for a reference.
Reference name
Company
Reference name phone number (no spaces)
Reference's email address

People who are 'at risk'
People who are classed as 'at risk' include people who are:
- aged 70 or older (regardless of medical conditions)
- under 70 with an underlying health condition (instructed to get a flu jab as an adult each year on medical grounds)
- Pregnant (please note this will remain confidential if you have not yet advised anyone of your pregnancy)
Are you classed as 'at risk'?
YesNo

People who are 'at risk' (continued)
Please provide further details.
Please tick which of the following risk categories that apply to you:
Aged 70 or older (regardless of medical conditions)Under 70 with an underlying health conditionPregnant

Shielding / Self-isolating
Have you been in contact with someone who displayed symptoms of COVID-19 within the last 2 weeks?
YesNo
Have you previously been advised to Shield?
YesNo
Are you self-isolating?
YesNo

Self-isolation details

Please let us know when you started self-isolation and, if possible, when your self-isolation will end.
Self-isolation start date
Self-isolation end date

Volunteering details
Please let us know which towns/cities (including the surrounding areas) you would like to volunteer for?
CorwenDenbighLlangollenPrestatynRhylRuthinSt Asaph
What hours / time are you able to commit to volunteering?
Are you able to speak Welsh or any other language?
You may come into contact with vulnerable adults who are showing symptoms, have COVID-19 or are recovering from COVID-19.
You will be provided with full Personal Protective Equipment (PPE) and training appropriate to the situation. Please bear this in mind when choosing the roles you'd like to volunteer for.
Would you be comfortable being around vulnerable adults who are showing symptoms, have COVID-19 or are recovering from COVID-19?
YesNo
Please select from the following options, which tasks and activities you would be happy to support with. (Please note, these may be within a Care Home/Providers setting or within the community with citizens' own homes.)
Collecting patients/residents from hospitalCleaning.laundryTelephone befriendingIn-person befriendingGeneral day-to-day helpCare work (excluding personal care)Other
If 'Other' please specify
Is there any assistance or resources that you would need from us to facilitate your volunteering?
Additional training
Are you currently trained in any of the following (please check any that apply):
Manual handlingSafeguardingFood hygieneOther
If other please specify below:
Skills and experience
Please provide any general information about your skills / experience you may believe to be useful:

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Apply for a volunteering opportunity: Covid-19 response volunteers

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