Application Form - Volunteer Form

NOTE: To apply print the completed form then mail or fax it to the address below.  This form can not be submitted  online.

Send the completed form below to:

Friends of STARTTS
 PO Box 203
Fairfield NSW 2165

Or Fax printed form to:  +61 (2) 9794 1910
____________________________________________________

Personal Information

Title:

Name:

Surname: 

Address:

Town:

State:

             

Post Code: 

Country:

Telephone (H): 

Telephone (W): 

Place of Birth:

E-mail:

Languages: 

 

Age (click one):  

Under 20

20-35

35-50

50-65

65+

When are you available (click one or more):  

    Days       Evenings        Weekends

 

Do you have use of a car?      Yes:     No:

Do you use Public Transport?   Yes:    No:

 

You are currently:  

Employed full-time 
Employed part-time
Home duties
Retired 
Student
Other   

 

What are your skills and previous work experience?

 

What are your hobbies and Interests?

 

Have you attended any Friends or STARTTS training or information sessions?  

Yes:    No:

Do you have an active workers compensation claim lodged?        

Yes:    No:

Have you ever been convicted of a sexual or violent offence?      

Yes:    No:

If yes, please give details:

 

Why do you want to become a volunteer at Friends of STARTTS?

 

Is there any reason why you would be unsuited to some areas of voluntary work?    
Yes:    No:

If yes, please give details:

I UNDERSTAND AND AGREE

  1. I will not divulge any information concerning clients of STARTTS to any outside sources.

  2. I will adhere to appropriate conduct and ethics during my voluntary work as a volunteer of Friends of STARTTS.

  3. To do voluntary work with Friends of STARTTS that I must be a financial member of Friends of STARTTS to be eligible for coverage for compensation if at all necessary.

  4. I acknowledge that any statement that is found to be deliberately misleading may terminate my membership of Friends of STARTTS.

 

Signature:  ____________________        Date:  

Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (NSW) Application Form