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Your spotlight on local services

Healthwatch St Helens Volunteer Application Form

(Please note that a Disclosure & Barring check will be necessary)


Please give the name and address of two referees. Your referees may be representatives from your current employment or voluntary placement. Otherwise from non-family members who have known you for a period of two years or more. Please ask the referees' permission first.

Contact Details for Referee One

Contact Details for Referee Two


Healthwatch St Helens is committed to Equal Opportunities and welcomes applications regardless of race, colour, nationality, sex, sexuality, marital status, caring responsibilities, age, physical, sensory or mental disability, or unrelated criminal conviction.

 The information contained in this form will be kept on file for a period of time and we will ensure all information is kept confidential and in accordance with current Data Protection Legislation.




I certify that, to the best of my knowledge, the information provided is correct and that by clicking "submit" constitutes a legal signature.

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