St Elizabeth Hospice Friends Data Collection

Confidential

  • Personal details


  • Emergency Contacts (NOK)


  • Criminal convictions/Probity declaration

    Because of the nature of the work undertaken by St Elizabeth Hospice, we require you to answer the following questions. Any information given will be completely confidential.

  • Do you have any convictions, cautions, reprimands or final warnings that are not “protected” as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975

  • Have you ever been disqualified from the practice of a profession or required to practise under specific limitations?

  • Are you the subject of any current investigation or proceedings by a professional or regulatory body in the UK or any other country?


  • Data Protection Act 1998 and General Data Protection Regulations 2018

    This form has been designed to provide us with sufficient basic information to add you to our supporter database. The information you supply in this form is confidential and will only be used by those involved in the appointment in line with the Data Protection Act 1998 and the General Data Protection Regulations 2018. For further information please refer to the GDPR information within the hospice’s privacy notice which can be found on the website.

    As a volunteer for St Elizabeth Friends groups, we will send you newsletters and information.


  • Keeping in Touch

    Please tick the boxes below, so that we can continue to share information and ask for your help.

    We will never pass on your personal information to third parties. You will automatically receive communication from us relating to your volunteering activities; in addition, we would like to contact you to inform you about other ways to support the hospice.

  • Wherever possible we will send communications electronically as this helps to save money on printing and postage costs.

    From time to time we may need to check with you to make sure you are still happy to be contacted in the same way you have chosen.

    If you decide to leave the hospice, we will ask you if you are still happy for us to contact you via the communication methods you have chosen above.


  • I hereby sign to the best of my knowledge that the above information is correct, and I understand that as a volunteer my details will be held on a secure database for the hospice use only.

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