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VOLUNTEER APPLICATION
Volunteer Application Form
Title
*
required
Please select....
Mr
Mrs
Ms
Miss
Dr
First Name
*
required
Last Name
*
required
Street No
*
required
Street Name
*
required
Suburb
*
required
State
*
required
Please select...
NSW
VIC
QLD
NT
WA
TAS
ACT
Post Code
*
required
Home/Mobile Phone
*
required
Work Phone
Which number is best for contacting you during the day?
*
required
Select one ...
Home
Mobile
Work
Email
*
required
D.O.B (DD/MM/YYYY)
Country of Birth
*
required
Cultural Background
Languages Spoken (other than English)
How well
Please select...
Limited
Good
Very fluent
Read & Write other Languages (other than English)
How well
Please select...
Limited
Good
Very well
Please list (briefly) all relevant Qualifications & Skills.
Please list your Experience.
What kind of volunteering work would you like to participate in?
ie. Day Excursion progrms: Art & Craft programs: Gardening programs: Administration: Community integration:
Why would you like to become a volunteer at North West Disability Services ?
ie. To gain experience, to become work ready, to do something worthwhile in your spare time etc.
Are there any issues that we may need to take into account?
ie. Health, disability, religious, cultural need etc.
Do you hold a current Drivers Licence?
*
required
Yes
No
If yes, what class?
Please select...
Learners Permit
Red Permit
Green Permit
C class
LR
HR
MR
International Licence
Would you consider upgrading your licence to LR?
Yes (LR enables you to drive our small buses)
No
On which days are you available to Volunteer?
*
required
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Are you available during
*
required
Day time
Evening time
For what period would like to do volunteer work?
Please select...
3 to 6 months
Longer than 6 months
Until I gain experience
Until I get a job
Please provide at least 2(two) Reerees (professional)
1. Name
*
required
Organisation
Relationship to you
Phone No
*
required
2. Name
*
required
Organisation
Relationship to you
Phone No
*
required
Emergency Contact person:
Name
Relationship to you
Phone No
Address
ALL volunteers MUST undergo a Police & Working with Children check.
Do you consent to a Police Check? (You will be given appropriate forms to complete.)
*
required
Yes
No
Do you consent to a Working with Children Check? (You will be given appropriate forms to complete.)
*
required
Yes
No
Upload Résumé/Cover letter
Mandatory field(s) marked with *
Our Services
Active Ageing
Attendant Care
Community Participation
HADPAC Social Support and Day Programs
Leisure Link Program
Life Choices Program
Day Programs
Post School Options
Accommodation Services
Recreational Programs
Teen Time Program
Transition to Work Program
Flexible Respite
Secret Garden
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