Downloadable Trustee application form - Easy Read

Application form for a volunteer Mencap Trustee with a learning disability - Easy Read

We are Mencap. These are our values :

A graphic of our 5 Mencap values: Brave, Positive, Passionate, Inclusive and Kind
A woman sitting at a desk with a pen in her hand about to fill out a form

You can apply to be a volunteer Mencap Trustee with a learning disability :

  • By post. Print out and complete this form and then post it to: The Governance team, Mencap, First Floor, East One, 20-22 Commercial Street, London. E1 6LP.
     
  • Online. Use our Easy Read webform
     
  • By video.  Record and send your video to the above postal address or by email to: [email protected]
     
  • In an audio file. Record and send your audio to the above postal address or by email to: [email protected] 

Your details

A group of people with different disabilities and ages

Do you have a learning disability?

Yes .........

No  ..........

Add your name

First name: ......................................................................

 

Last name: ......................................................................

A calendar showing June 1972 with Friday 10th circled in red next to a picture of a baby

Date of birth: ................. / ........................ / .........................

A house with an envelope with the address written on it

Address: ............................................................................

               ............................................................................

               ............................................................................

               ............................................................................

Postcode: ..........................................................................

A piece of paper with a person's name and telephone number written on it.

Phone number: ......................................................................

a computer screen showing an email address

Email address: .......................................................................

A woman in a wheelchair with a speech bubble that reads "I need..." with a clock, easy read page, and ramp representing reasonable adjustments.

Do you have any support needs?

Yes: .....................

No:  .....................

If yes, please tell us about them and what they are so that we can support you:

 

 

 

 

 

 

 

 

 

 

                                                                                                                                                                                                             

A clipboard with a pen and a health questionnaire on it

Do you have any medical conditions that you would like to tell us about?

Yes: .............

No:  .............

If yes, please tell us about them:

 

 

 

 

 

 

 

 

 

 

                                                                                                                                                                                                             

Two men standing next to each other. One is showing the other a piece of paper

If you are a Trustee you will get the support that you need and support that we can give you

You will get support from the Governance team in your role as a Trustee.

Please read the list of support that Mencap can give you.

Have you read the list of support that Mencap can give you?

Yes: ........................

No: .........................

A lady in a wheelchair saying I need, with a ramp, a stopwatch and easy read information and a green tick.

Please tell us what reasonable adjustments you would need at the Trustee interview and in the Trustee role:

 

 

 

 

 

 

 

 

 

 

                                                                                                                                                                                                             

Trustee application form questions

A man pointing to himself.

Tell us a little about yourself? If you have any experiences of work it would be great to hear about them too. 

 

 

 

 

 

 

 

 

 

 

                                                                                                                                                                                                             

A woman flexes her arms above the word "strengths"

What are your strengths and skills?

 

 

 

 

 

 

 

 

 

 

                                                                                                                                                                                                             

A woman wearing a Trustee badge on her Tshirt

How would you explain what it means to be a Mencap Trustee?

 

 

 

 

 

 

 

 

 

 

                                                                                                                                                                                                             

A man smiling

What do you think you’ll enjoy the most about being a Trustee for Mencap? 

 

 

 

 

 

 

 

 

 

 

                                                                                                                                                                                                             

A map of the UK with people

How would you like the United Kingdom to be different for people with a learning disability? 

 

 

 

 

 

 

 

 

 

 

                                                                                                                                                                                                             

Data protection and declaration

A woman with her finger on her lips and a sign saying Confidential

Data is another word for information.

We follow Data Protection rules.

Data Protection rules mean you have to be really safe when using someone’s personal information, to make sure it is only seen by the people that really need to see it.

The front cover of the Data Protection Act, a mobile phone and a woman with a finger to her lips

How will my data be used at Mencap?

All the personal information you give to us will be kept safe and will only be seen by the Governance team.

A years calendar with x 7 next to it

How long will Mencap keep my personal data for?

We will keep the information you send us for 7 years.

A drawing of a consent leaflet with a big green tick on it

Your declaration

By completing, signing, and sending this form to Mencap, I agree that:

  • The information I have given is true.
  • I agree that if any information is not true, or if I have missed out any important information, I may not be able to get the job as a volunteer Mencap Trustee.
  • I have read and understood Mencap's Privacy Policy about how Mencap will manage my data.
A hand holding a pen writes a signature along a line

Sign to agree:

.................................................................................................................................................

A page from a calendar which says 'Today' with the date, month and year numbers underneath it.

Today's date is: ........................ /................................. / ..................................

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Print out and fill in this form, then post it to: The Governance team, Mencap, First Floor, East One, 20-22 Commercial Street, London. E1 6LP.

Your completed application form needs to reach us before 12pm on Friday 29 May 2026.