Home-Start GreenwichVolunteer Impact Management System (VIMS)

Monitoring Form

Home-Start Greenwich is committed to safe recruitment practice as an important part of safeguarding and protecting children and vulnerable adults

The information you give in this form will not be used for volunteer selection purposes. It helps us to get an overall picture of our volunteer team in comparison with the families we support and the communities we live in. Although this section is optional, we would really appreciate your participation as it can often assist in funding bids and awareness raising.

Age Range:16-24 25-34 35-44 45-54 55-64 Over 65

Gender Sexual Orientation

MaleHeterosexual

FemaleLesbian

TransgenderGay

No Response given Bi-sexual

Disability No Response given

Do you consider yourself to have a disability? Y/N Please specify

Housing (please tick all that apply)Privately Owned Privately Rented Social HousingTemporary Housing (e.g. B&B, Refuge) Other (please specify)No Response given

Immigration StatusAre you a British Citizen/national of European Economic area? Y/N

Do you have the right of residence in the UK? Y/N

Are you an asylum seeker? Y/N

Asian or Asian BritishBlack or Black British White

Indian Caribbean British

Pakistani African Irish

Bangladeshi

Any other Asian background Please specify

Any other Black backgroundPlease specify

Any other white background Please specify

Chinese or other ethnic group Mixed

Chinese Any mixed background Please specify

Other No Response given

Immigration StatusAre you a British Citizen/national of European Economic area? Y/N

Do you have the right of residence in the UK? Y/N

Are you an asylum seeker? Y/N

No Response given

Religious Beliefs Please specifyNo Response given

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How did you hear of Home-Start? (please tick all that apply)a) Internet

b) Newspaper advert

c) Local radio

d) Word of mouth: e.g. another volunteer, a friend

e) Leaflet through letterbox

f) A story in a paper/magazine

g) Received support as a Home-Start family

h) Local voluntary organisation

i) Home-Start newsletter

j) Previous Home-Start experience

k) Other, please specify ..............................................................

For Office Use: ID: Date rcd:

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