Volunteer Application Form

Volunteer Application Form
Personal Details

All information shared is treated confidentially
Name

First NameLast Name
Preferred Name
Email Address
Phone Number

Area CodePhone Number
Identity Number
Date of Birth

MonthDayYear
Gender
Marital Status
Race
(statistical purposes only)
Nationality
Religious Affiliation
(used to match prayer families)
Home address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Postal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Drivers Licence
Own transport
Police Clearance Certificate Attached (Compulsory)
Attach

Upload a File

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Training, Qualifications, Natural Gifts and/or Talents

This information is used to assist us to determine in which ways we are able to make use of your service
Describe your skills and talents
Previous Volunteer Work or Work History
Do you currently (or have you ever) suffered from any of the following?
Clinical Depression
Fainting Spells
Epilepsy
High/Low Blood Pressure
Other
Emergency contact details
Name

First NameLast Name
Relationship
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
What has motivated you to want to volunteer for the My Child Has Cancer Trust?
Explain your motivation
Preferences in Volunteering

Other
Available Dates and Times
(e.g every Monday from 10 until 12 for 6 months)
References

Due to the nature of the work you will be doing, we conduct references on all our volunteers. Please provide names, addresses and telephone numbers of two referees, preferably one employer and NOT family members.
REFERENCE 1
Name
Position
Phone Number

Area CodePhone Number
E-mail
Address
REFERENCE 2
Name
Position
Phone Number

Area CodePhone Number
E-mail
Address
References
Confidentiality
Indemnity
Should be Empty:

Volunteer Application Form

Personal Details

Training, Qualifications, Natural Gifts and/or Talents

Previous Volunteer Work or Work History

Do you currently (or have you ever) suffered from any of the following?

Emergency contact details

What has motivated you to want to volunteer for the My Child Has Cancer Trust?

References