Volunteer Registration Form

Volunteer Application Form

Please complete and submit the below form if you would like to become a volunteer for the safe shelter in Ulladulla. We will be in contact with you shortly and appreciate your support.
Full Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*
Date of birth*

DayMonthYear
Date
Gender*

MaleFemale
Are you a member of a church? If so, which one?

Preferences in Availability:

Preferences in Duties

Any Special Comments
Emergency Contact Details
Name*

First NameLast Name
Relationship
Phone Number*
Other Information
Do you have a drivers license?*

YesNo
Do you have First Aid Qualifications?*

YesNo
Do you have Mental Health First Aid Qualification?*

YesNo
Working With Children Check (WWCC)
https://www.service.nsw.gov.au/transaction/apply-working-children-check
Do you have a WWCC?*

YesNo
What is your WWCC number?*
WWCC Number
WWCC Expiry Date:*

MonthDayYear
WWCC Expiry Date
Do you have any medical issues that may impact on your volunteer work?*
How often would you like to volunteer?:

1 night per week1 night per fortnight3 weekly1 night per month
What previous volunteering (if any) / experience do you have and with who?
Other information (include prefered nights here e.g every 2nd Tues and any relevant qualifications here):
I hereby agree that the personal information on this form will be used for the purposes related to Safe Waters Community Care Inc. safe shelter project. This information will not be disclosed outside of this. I understand that my volunteer duties may require a police check.*
Please sign/print your name here
Should be Empty:

Now create your own Jotform - It's free!Create your own Jotform

Volunteer Application Form