Time Swap membership form

Tell us about your talents.

If you're interested in becoming a Time Swap member please complete the membership form.

Time swap membership form

Time Swap membership form

Note: Asterisks (*) indicate required information.

errorPlease correct the information in the fields highlighted below.
Personal details

Mobility & transport

Please give details of any disabilities or mobility problems. This is to give us an indication of assignments that would or would not be suitable for you.

Emergency contact

Volunteering past & present

Criminal convictions

If you have a police record, you can still volunteer, however the nature of volunteering is such that you are exempt from the Rehabilitation of Offenders Act 1974. In some cases a police check may be required because of access to vulnerable people.


In case of a medical emergency when taking part in a Time Swap Exchange please provide your doctors information.

Where did you hear about Time Swap?


Please provide two names, addresses, telephone numbers and, where applicable, email address, for people you have known for at least two years; i.e. a relative, friend, doctor or colleague; they will be contacted for a reference. This is so that as a Time Swap member you and everyone else in the Time Swap initiative are safe.

If you experience any problems with this form please contact contact.centre@derbyshire.gov.uk and quote form ID: ILF/581/09