Volunteering

Title: Miss Mr Mrs Ms

First Name: Last Name:

Date of Birth:

Address:

Suburb:

Postcode:

Phone:   Work Phone:

Mobile

E-mail Address:

Best time(s) to contact you:

I am interested in the following volunteer positions (please check the boxes of those you would like to apply for). Click on the Position Name to re-read the position descriptions:

 Activity Assistant - Spinning
 Assistive Technology Technician
 Audio Monitor
 Audio Narrator
 Braille Proof Reader
 Braille Transcriber – Library
 Confident Living Program Volunteer Driver
 Audio Monitor
 Gym Assistant / Transport Driver
 Handicraft Assistant
 Literacy Program Tutor
 Manual Arts / Woodwork Assistant
 Puppy Walker
 Pool Walking Assistant
 Pottery Assistant
 Public Relations Volunteer
 Tandem Cycling Front Rider
 Ten Pin Bowling Assistant
 Toy Library Assistant

Please provide us with a brief personal/professional biography to let staff know a little bit about you. It will be published, along with a photo (either supplied by you or taken by us), on our in-house Staff Intranet when you commence as a volunteer.

Any qualifications, experience or other skill

Any languages (other than English) that you speak:

Your Availability for Volunteering:

All Day Monday:

 All Day Tuesday:

 All Day Wednesday:

 All Day Thursday:

 All Day Friday:

 All Day Saturday:

 All Day Sunday:  

How often do you wish to volunteer?

 per week
 per fortnight
 per month
 other (please specify)

Medical or Health Issues

Do you have (or have you had) a medical or health problem which may affect your volunteer work, or that we should otherwise know about in the event of an emergency? Yes No

If you answered Yes to the above question, please provide details of your medical condition:

Contact Details (in the event of an emergency)

Next of Kin / Preferred Contact Person Name:

Relationship:

Address:

Phone:

Transport

Some positions require that you drive your own car, or drive one of the Association vehicles during the course of your volunteer duties. If this applies to any of the positions you are interested in, please complete the Licence and Vehicle information below:

Drivers Licence No:

Do you have your own vehicle?  Yes  No

If you answered Yes to the above question, please provide details of your vehicle

Make:

Model:

Vehicle is Insured with:

Type of Cover:

Amount Insured for:

Background Reference and Police Clearance
All Association staff and volunteers must have a Police Clearance and provide the name of a Referee.

Name of Referee:

Daytime Phone Number:

Occupation or Position:

I give permission for my nominated Referee to be contacted  Yes     No

National Police Clearance We can arrange a Volunteer Police Check  for you at no charge. A form will be sent to you once we receive your online application. However, if you require a full clearance for other reasons, this is obtainable from your local Police Station at a cost of $41 (exact change required by the Police) and can usually be supplied while you wait. The Association requires this clearance prior to commencement of any volunteer duties.

Confidentiality

Volunteers will be required to sign the Association's Information  Confidentiality agreement. Volunteer Induction Sessions
All Association volunteers need to attend an Induction Session before commencing their role. Thank you for taking the time to complete the Volunteer Application Form. Please check to make sure you have provided all the necessary information and then click on the "Submit Form" button below to complete your application.