Wufoo

Companion application form

This form is to be completed by all those applying to be a companion with Camp Quality UK. The intent of this form is two-fold:
1. To help Camp Quality UK provide a safe and secure environment for those children and young people who participate in it’s programmes and activities.
2. To assist Camp Quality UK in matching the applicant’s abilities to the needs of particular holidays.
--Please email delyth@campquality.org.uk if you have any questions about this form.--
Please note: you need to be over 17 and have lived in the UK for at least 3 years to be a Camp Quality UK companion.

Your details (1 of 5)

Your name, contact details and date of birth
Name * Title First Last Suffix
Address line 1 *
Address line 2
City (Postal town) *
Postcode *
HOME Town - please read note>>>

If you are at university during term time and another town in the holidays, please let us know where your "home town" is, if different to the address given above
Contact number 1 *

We will use this as your main number
Contact number 2

It's useful to give us a second number in case you lose your phone, change your number or if we just can't get through to you. This can be your parent's number, for example.
Email address - please read note>>> *

Uni or work email addresses expire when you leave, so please use a personal email that will be with you wherever you are!
Date of birth * DD / MM / YYYY
Example: If you were born on 1st March 1990 enter: 01/03/1990
Sex *
Male Female
Occupation and place of work

Students: Please enter the title of your course and university (or equivalent) and date of graduation
Your strengths (2 of 5)

A bit about you and your experience
Why do you want to become a Camp Quality UK companion?

What would you like to get out of it?
What experience have you had working with children? Please list any past Camp Quality UK holidays you have attended.

Include details of time that you have spent with children through work, volunteering or at home.
Do you have any skills, education, abilities or talents that you think will come in useful on camp?

List anything here that you haven't mentioned already
A little more about you (3 of 5)

Shirt sizes, availability and medical information
What is your (adult) shirt size? *

You may be given a poloshirt or tee shirt for the camp
Which camp(s) are you available for?
New Barn 1st-3rd August 2009 (5-7yrs) Low Mill 4th-6th September 2009 (11-14yrs) Overstrand 6th-8th November 2009 (14-16yrs)
References (4 of 5)

Please provide a referee who has known you for 2 years or more and who lives in the UK. They must not be a member of your family. We may contact them and ask them about you. This is in addition to a CRB check which will be carried out at a later date.
Name of referee * Title First Last Suffix
Address and postcode of referee *

Full address and postcode of referee
Contact number for referee *

Please give a number we can easily contact them on
Relationship to referee *

How does this person know you and for how long?
Declaration (5 of 5)

Please read the declaration below very carefully. The Guidelines for Companions and Staff can be found here: www.campquality.org.uk/how-you-can-help/non-medical-volunteers
I certify that all the information given by me in this application is true and correct to the best of my knowledge. I agree that, should my application become successful,
I will hold myself bound by the rules and policies of Camp Quality UK and in particular by the Guidelines for Companions and Staff which I have read and understood.
I am not currently under investigation for any offence.
I give Camp Quality UK permission to contact my referees and obtain information about me. I hereby waive any right to inspect references so given.
We may use your contact details to process your application and let you know about any news at Camp Quality UK. We will not pass your details onto a third party, unless stated otherwise. *
I agree to and accept these terms and conditions

Read the attached file before signing this form
Do Not Fill This Out

Wufoo

Companion application form

Your details (1 of 5)

Your strengths (2 of 5)

A little more about you (3 of 5)

References (4 of 5)

Declaration (5 of 5)