Main Office:
188 McDonalds Road
Epping Vic 3076
P: (03) 8401 0100
F: (03) 9408 0501
E:
info@kildonan.org.au
VOLUNTEER APPLICATION FORM (SEPT 2007)
Title:(Mr/Mrs/Ms) ________Surname:_____________________________________
Given Name: ________________________________________________________
Address: __________________________________________Post code: _________
E-mail:______________________________________________________________
Phone: (after hours)______________________(business hours)_________________
Mobile:_______________________________________________________________
Date of birth:_______________ Languages spoken:___________________________
Person we may contact in case of emergency:________________________________
Relationship to you: ___________________________Phone:___________________
1. Referees (provide two referees who can be contacted in relation to your
application)
(i) Name: _________________________________________________________
Occupation: _____________________________________________________
Address:________________________________________________________
Phone: ____________________Relationship to applicant:_________________
(ii) Name: _________________________________________________________
Occupation: _____________________________________________________
Address:________________________________________________________
Phone: ____________________Relationship to applicant:_________________
2. What is your background in terms of work and volunteering? Where
have you worked/volunteered and what have you done?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Kildonan UnitingCare 1
3. If you have volunteered before, what was this experience like?
_______________________________________________________________
_______________________________________________________________
4. What training have you completed (any area)? _____________________
_______________________________________________________________
5. What type of volunteer work would you particularly like to do and why?
_______________________________________________________________
_______________________________________________________________
6. What skills do you bring which you would like to use in your voluntary
work with Kildonan? _______________________________________
______________________________________________________________
______________________________________________________________
7. What are your experiences of working as a member of a team and what
you see as some of the challenges of team work for you? ____________
_________________________________________________________
_________________________________________________________
8. Are there any issues/problems to do with your previous work or
volunteering which would be important for Kildonan to be aware of?
_______________________________________________________________
_______________________________________________________________
9. Are you prepared to authorize us to undertake a criminal records check
of your name with police? Yes/No
10. Do you have a current Driver’s Licence? Yes/No
Driver’s Licence Number: ___________________Expiry Date:_______
Kildonan UnitingCare 2
Main Office:
188 McDonalds Road
Epping Vic 3076
P: (03) 8401 0100
F: (03) 9408 0501
E:
11. Are you aware of a pre-existing injury or impairment info@kildonan.org.au
which may be adversely affected by performing tasks
associated with volunteering at Kildonan?: Yes/No
If yes, please provide details: _____________________________________
_________________________________________________________
A false or misleading statement or failure to disclose relevant
information may mean that you will not be entitled to compensation if a
condition is aggravated.
What is your general state of health? ___________________________
WORKING WITH CHILDREN CHECK (Originals will need to be produced - if
appointed)
Application Lodgment Receipt Number:_________________________________
Date Lodged with Australia Post:_______________________________________
Or
Working with Children Card Number:____________________________________
Expiry Date: ______________________ Type (E) or (V) ____________________
12. Is there a particular Kildonan program you wish to be involved in
Yes/No. Please
detail:___________________________________________________
13. Indicate which sites you are wishing and or are able to volunteer at:
Epping € Collingwood € Heidelberg € Coburg € Reservoir €
Kildonan UnitingCare 3