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Application for the position of volunteer support group facilitator

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Please check all the boxes to indicate when you could be available:
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References Please give details of two referees (not related to you) who have known you for at least 2 years:
Reference one
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Reference two
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Data Protection Act 1998

Information on our database is strictly confidential and we do not pass on any personal data about you to outside organisations and/or individuals without your express personal consent. Please indicate if you agree that we may:
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Emergency Contact:
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