Volunteer application form

Indicate which of our services you are interested in supporting, and which roles.

ServicesPSECEnliven DisabilityEnliven Older PeopleFamily Works

Preferred locationNapierTaradaleHavelock NorthHastingsGisborne

RolesShop volunteerShop team leaderOffice/administrationEnliven Centre supportEnliven Centre activityFamily Works donated goods/bakingMosaic Centre supportRowan House supportEvent assistanceStreet Appeals

Please let us know how much time you'd be prepared to give

Frequency WeeklyFortnightlyMonthly

Hours per session1 to 23 to 44 to 6more than 6MorningAfternoonEvening

DaysMondayTuesdayWednesdayThursdayFridaySaturdaySunday

Why are you interested in volunteering with PSEC?

What experience or skills can you bring to the organisation?

Upload your CV (optional) (20MB max)

Do you have any medical conditions or physical limitations that may affect your work as a volunteer, or may affect your safety and that of your colleagues?

Do you have any criminal convictions, or are you awaiting the hearing of any charges in a court of law?

Do you have any criminal convictions, or are you awaiting the hearing of any charges in a court of law?NoYes

If yes, please give details

Do you consent to a full Police check?YesNo

Please provide a referee we can contact to establish your suitability for volunteering

Name

Relationship with you

Daytime phone

Cellphone

Our clients and families involved with Presbyterian Support East Coast are accorded confidentiality. As a volunteer with this organisation I agree to respect and maintain this trust.

I agree to my name and phone number being used with Presbyterian Support East Coast. The personal information contained in this form will be held by and remain confidential to Presbyterian Support East Coast.

Under the Privacy Act 1993, you have the right (with certain exceptions) to request access to, and correction of, any personal information held by us.

I declare that all the information provided by me in support of my application is correct.

I acknowledge that if I have provided incorrect or misleading information, or have omitted information of significance I may be disqualified from becoming a Volunteer, or if appointed, be liable to be dismissed.

Signed

Date