The Whitechapel Centre
0151 207 7617
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    Personal Details


    ​We recognise that personal experience can offer a depth of understanding of the needs and aspirations of those with complex needs. Please complete the questions below with as much detail as possible.

    ​In order to match you with a suitable service user, we need to know more about you to enable you to build a successful mentoring relationship.

    Supporting the Peer Mentor

    We place great importance on recruiting people from all sections of the community and we are keen to support our volunteers at every stage. Please use this space to tell us about your own specific needs, if any. These could be related to physical or mental health, mobility, religion, culture or any other matter that you feel is important for us to know. We welcome applications from former service users. We appreciate that additional support might be required, please tell us about this. 

    References

    Please provide the full details of two people who can provide you with a reference. These may be former employers, places where you have volunteered, or people who know you in a professional capacity e.g. key hostel worker, support worker or social worker etc

    Name Email Address Mobile Relationship
    Name Email Address Mobile Relationship

    Background Checks

    The Whitechapel Centre welcomes applications from ex-offenders as part of its Equal Opportunities Policy. There are occasions where ex-offenders may be put into potentially vulnerable positions unless the persons background has been taken into consideration at the outset. For this reason we ask you to complete the following section:                                       
    I declare that the information given in this form is complete and accurate.  I understand these details will be held in confidence by The Whitechapel Centre for the purposes of assessing this application, ongoing personnel administration and payroll administration (where applicable) in compliance with The Data Protection Act 1998.

    Equal Opportunities

    The Whitechapel Centre is committed to ensuring that applicants, volunteers and employees from all sections of the community are treated equally and not discriminated against on the grounds of gender, colour, race, nationality, marital status, religion or belief, sexual orientation, disability or age.
     
    This form assists us in monitoring who is applying for employment with us, our adherence to equal opportunities best practice and our progress towards identifying any barriers to diversity among our workforce.  We ask some questions regarding disability which may also assist us in determining whether any reasonable adjustments are necessary to facilitate your interview. [This form will be separated from your application on receipt, but if you are subsequently employed by us then we may retain it on your personnel file.]  
     
    We would be grateful if you would fill in this form and return it with your application. You are not obliged to answer all the questions but the more information you supply, the more effective our monitoring will be.  All information supplied will be treated in the strictest confidence.
     
    Thank you for your assistance.
    Can include "I am not religious" and "prefer not to say"
    Please write your name here.
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The Whitechapel Centre
Langsdale Street
Liverpool
L3 8DT
Tel: 0151 207 7617
Fax: 0151 207 4093


Charity Number: 1013060
Reg Co Number: 2623071
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