Carrington Health VolunteerInformationForm
PersonalDetailsFirstName: / Last name(s):
Postal Address: / Suburb: / State:
Postcode:
Email Address:
Telephone: / Home: / Mobile: / Work:
Doyou havea currentDriver’sLicence? / Yes/No
Employmentand/orVolunteeringHistory
Haveyou worked/volunteered atCarrington Healthbefore? Yes No
Whatwasyourmostrecentpaid position? / Position: / Organisation:
Whatwasyourmostrecentvolunteerrole? / Position: / Organisation:
SkillsandQualifications
Note any work experience or qualifications you may have:
AvailabilitytoVolunteer
Hours per Week: / StartDate:
PreferredDays: / Monday / Tuesday / Wednesday / Thursday / Friday
Preferred Times:
Do you accept to be on our registry for future interest in volunteering YES / NO (Only this position)
Languages(OtherThanEnglish)
Referees
Please providethecontact details ofonepersonwhoisnot family andwhois willing to act as your referee.
Referee Name: / Relationship: / Howlonghaveyou knownthisreferee?
Phone: / Mobile: / Email:
Declaration
I am applyingforvolunteerworkwith Carrington Health.
I agreeto uphold andworkwithinCarrington Health values whilstcarryingout my volunteerdutiesandwhen representingCarrington Health.
I agreeto maintainthehigheststandardsofconfidentialitywithrespecttoanyinformationobtainedduring thecourseofmyvolunteerwork.
Iunderstandthat I am requiredtoparticipatein an interview andselectionprocess,undertakea reference and Police Check, including a Working with Children Check for child related roles. I understand that an offer of volunteering is conditional on successful clearance in these areas.
IunderstandthatIwillbe requiredtoundertakeinductionand programtrainingpriorto my commencement.
Signature: Date:
Privacy Statement
Your privacy is our priority. Carrington Health abides by the National Privacy Principles in all its dealings with volunteers and the public. The personal information will be treated as confidential.
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