Get Involved

Arab Chaudhry, Therapeutic Services Manager works
Tuesday to Thursday 9am-5pm

Claire Chalmers – Assistant Manager, works
Tuesday 8:45am-3.45pm and Wednesday and Thursday 9am-5pm

Volunteer Application Form

Thank you for your interest in volunteering with PMH Borders. The information you provide on this form will be treated in confidence.

1 Role

2 Contact

3 History

4 References

5 Statement

Role Applied For

Position applied for *

Where did you hear about this volunteering opportunity?

Contact Details

First Name *

Surname *

Address *

Postcode *

Home Telephone

Mobile

Email Address *

Do we need to make any specific arrangements in order for you to attend the interview? *

Yes No

If yes, please give details

Are you currently a member of the PVG Scheme? *

Yes No

Employment, Volunteering and Education

Starting with the most recent, please include previous employment or volunteering and account for any gaps.

Employment / Volunteering History 1

Employment / Volunteering History 1 - Name of Employer

Employment / Volunteering History 1 - Job Title

Employment / Volunteering History 1 - Address and postcode

Employment / Volunteering History 1 - Employed from

Employment / Volunteering History 1 - Employed to

Employment / Volunteering History 1 - Salary

Employment / Volunteering History 1 - Reason for leaving

Employment / Volunteering History 1 - Summary of duties and responsibilities

Employment / Volunteering History 2

Employment / Volunteering History 2 - Name of Employer

Employment / Volunteering History 2 - Job Title

Employment / Volunteering History 2 - Address and postcode

Employment / Volunteering History 2 - Employed from

Employment / Volunteering History 2 - Employed to

Employment / Volunteering History 2 - Salary

Employment / Volunteering History 2 - Reason for leaving

Employment / Volunteering History 2 - Summary of duties and responsibilities

Education, training and qualifications

References

Please give two referees. PMH Borders will only contact referees if you are offered the position.

Reference 1

Reference 1 - Name *

Reference 1 - Job title

Reference 1 - Relationship *

Reference 1 - Organisation

Reference 1 - Address

Reference 1 - Postcode

Reference 1 - Telephone

Reference 1 - Email *

Reference 2

Reference 2 - Name *

Reference 2 - Job title

Reference 2 - Relationship *

Reference 2 - Organisation

Reference 2 - Address

Reference 2 - Postcode

Reference 2 - Telephone

Reference 2 - Email *

Personal Statement and Declaration

Personal Statement *

I confirm to the best of my knowledge that the information in this application form is true and correct. *

Signed *

Date *

info@pmhborders.org.uk

East Lodge, Elm Row, Galashiels, TD1 3HT

01896 751 609

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