Please provide the full names, dates of birth and ethnic origin of everyone living in your home, including children. (Please note, ethnic origin information is for our monitoring purposes only):
Please note, we will be regularly reviewing the placement and will review initially after one week and then one month. (Please tick all that apply).
Please provide the names and contact details of two referees. One must be someone who has known you for over two years and the other must be someone who has known you recently in an employment / voluntary capacity.
Please note, referees must not be family/household members or close friends.
Data Protection & Consent
We value your support and promise to respect your privacy. The data we gather is managed in accordance with the GDPR 2018. We will not disclose or share personal information without your consent.
I give Hope at Home my consent to carry out checks with the Disclosure and Barring Service (DBS) and to contact two personal referees. I also give consent for Hope at Home to store my personal application information for the purpose of the administration of the scheme.
By signing this form, I am confirming that I have read the attached Data Privacy Notice and that am consenting to Hope at Home holding and processing my personal data for the following purposes (please tick the boxes where you are happy to grant consent):
You can grant consent to all the purposes; one of the purposes or none of the purposes.
You can grant consent to all the methods; one of the methods or none of the methods.
Where you do not grant consent, we will not be able to use your personal data except in certain limited situations, such as where required to do so by law or to protect yourself or members of the public from serious harm.
If you do grant consent, please note you can withdraw your consent to all or any one of the above purposes at any time by contacting Hope at Home (firstname.lastname@example.org)and requesting this in writing.
Please note that all processing of your personal data will cease once you have withdrawn consent (unless there are safeguarding/legal reasons preventing this) but this will not affect any personal data that has already been processed prior to this point.
Please also note that we also require all volunteers to have undertaken an enhanced DBS Check with barring information before starting to host.
Names and signatures of all those over the age of 18 living in the home: