Volunteer Application Form
Please complete and submit the below form if you would like to become a volunteer at our safe shelter in Ulladulla. We will be in contact with you shortly and appreciate your support.
Full Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
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Algeria
American Samoa
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Belgium
Belize
Benin
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Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
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Cameroon
Canada
Cape Verde
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Christmas Island
Cocos (Keeling) Islands
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Eritrea
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Liberia
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Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
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Uzbekistan
Vanuatu
Vatican City
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Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
E-mail
*
Phone Number
*
Date of birth
*
-
Day
-
Month
Year
Date
Gender
*
Male
Female
Other
Preferences in Availability:
5pm - 9pm
9pm - 9am
Sleepover
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Any Special Comments
Emergency Contact Details
Name
*
First Name
Last Name
Relationship
Phone Number
*
Other Information
Do you have a drivers license?
*
Yes
No
Do you have First Aid Qualifications?
*
Yes
No
Other
Do you have Mental Health First Aid Qualification?
*
Yes
No
Other
Working With Children Check (WWCC)
Please note: all volunteers must have a WWCC, please see link below to start application: If you have started a new WWCC application, please insert application no. below and you can send us your WWCC once approved after registration.
https://www.service.nsw.gov.au/transaction/apply-working-children-check
Do you have a WWCC?
*
Yes
No
What is your WWCC number?
*
WWCC Number
WWCC Expiry Date:
*
-
Month
-
Day
Year
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 week
1 night per fortnight
3 weekly
1 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.
*
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