Befriender Application

Thank you for expressing an interest in volunteering with Befriend Motherwell.  Volunteers are hugely important to us and without their help we would be unable to offer the service we provide.  We would appreciate you taking a few moments to complete this online application to allow us to find out some more about you and more you onto the next stage.”

    Your Email (required)

    Home Address

    Your Postcode

    Your Home Number

    Your Mobile Number

    Emergency Contact Name

    Emergency Contact Number

    Emergency Contact Relationship

    Do you consider yourself to have a disability?

    If yes, Describe

    Are there any areas of support you may need to enable you to volunteer with us?

    What made you want to volunteer with Befriend Motherwell?

    To help us match you with a suitable befriendee it would help us if you could provide some information around what interests or hobbies you may have?

    What age group are you?
    Under 4040-4950-5960-6465+

    What gender are you?

    Would you prefer to befriend someone of the same gender?
    YesNoNot important

    Do you smoke?

    Do you mind if your Befriendee smokes?

    Anything else you’d like to tell us about yourself?