Volunteer Application Form

Your Name

First name

Last name

Titile

Address

Address line 1

Address line 2

Address line 3

Address line 4

Town/Suburb

City

Postcode/Zip

Home phone

Cell phone

Email address

Have you been a volunteer for any organisation? - If so where and when.

Can you tell us a little bit about yourself? - what you enjoy doing and if you have any special attributes that you feel could benefit Hospice.

Do you have any health conditions that may affect the type of volunteering you could do?

Do you have a current drivers licence?

There will be an orientation and education given. Are you prepared to abide by Hospice South Canterbury policies and procedures?

Please tell us what type of volunteering you are interested in:

Cooking

Patient contact roles

Cooking (evening meal) - This role can be done in pairs.

In - patient unit (breakfast meal)

The Community Cottage (Mondays Only)

The Cottage Driver (Mondays Only)

68 Orbell Street Shop - (Monday - Saturday)

54 Church Street Shop (Tuesday to Saturday)

54 Church Street Shop (pick up and Deliveries)

Fundraising

Flower arranging

Gardening

Driving

Please let us know what days suit you and if it would be AM or PM

When would you like to start?

The personal information contained in this form will be held by and remain confidential to Management of South Canterbury Hospice. Under the Privacy Act 1993, you have the right (with certain exceptions) to request access to and correction of, any personal information held by Hospice. You may also be asked for a CV if you have one.

We require that all people representing Hospice be subject to a police check. Please do not take offence at this requirement.

I Declare that all information provided by me in support of my application is correct. I acknowledge that if I have provided misleading information of significance I may be disqualified from becoming/continuing a volunteer.

Thank you so much for your application. Our volunteers are the backbone of our Hospice. We could not offer the service we do without volunteers.

Once again Thank You

Bronwyn Simons
Manager of Volunteering

Please check the highlighted fields

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