Volunteer Applications

Consent for storing submitted data *

Yes, I give permission to store and process my data

See our Privacy Policy listed on our website.

First Name *

Surname

Email *

Daytime Phone Number *

Your preferred number, can be a mobile

Current place of work *

Hospital, university, company etc. We do not need the address

Membership Number

Please leave blank if you can't find it

In what area of the profession do you work in, what do you do? *

Please state your specialism / interest and your current role / work.

Please indicate if you have any of the specific areas of experience, skills and attributes as outlined in the role description and eligibility criteria document. *

Please state how your skills, enthusiasm, experience can help IPEM achieve the aims and objectives of this group? Why do you want to get involved? *

Optional - have you done any previous volunteering? (with IPEM or outside of IPEM) *

If applicable please include approximate dates and role and comment on what experience, skills or knowledge you gained.