100 Hour Sign Up

Have you completed 100 hours of volunteering since April 2007? Do you think you will complete 100 hours this year? If so please complete the form below and sign up to our 100 hours award scheme.

Name: *

Address:

Town:

County:

Post code:

Email Address: *

Telephone Number:

Volunteering Details (Please let us know the details of your volunteering. ie. where you volunteered and the number of hours):

How would you describe your ethnicity?:

Do you consider yourself to have a disability?:

Yes

No