Volunteer Application Form: General Which role are you applying for?*Your detailsName* First Last Address* Street Address City ZIP / Postal Code Phone*Email* Country of birth*Languages spoken other than English*Qualifications, skills and experiencePlease list a short description of your relevant qualifications, skills and experience.Qualifications*Skills*Experience* Why would you like to volunteer at North Richmond Community Health (NRCH)?*Please let us know of any health, disability, religious, cultural factors or pre-existing injuries that you would like us to take into account as well as any medication you are taking which may affect your work.For what period would you like to undertake volunteer work with NRCH?* 3 months 6 months Until I get experience Until I find employment Ongoing Do you have a current Working With Children's Check?* Yes No Do you consent to a Police Check?* Yes No ResumePlease upload your resume to this application (optional)Referee 1Referee's full name*First referee's phoneReferee's email Referee's relationship to you?*Referee 2Referee's full name*Referee's phoneReferee's email Referee's relationship to you?*Emergency contact personFull name*Phone*Address* Street Address City ZIP / Postal Code Relationship to you*Declaration* By ticking this box, I declare the information I have provided in this form is true and correct Date* Date Format: MM slash DD slash YYYY What will happen next?If your application is successful, you will be invited for an interview. QueriesPlease contact our Volunteer Coordinator, Selma Sali with any queries. Mail: North Richmond Community Health Ltd, 23 Lennox Street, Richmond 3121 Ph: 9418 9893 Fax: 9428 2269 Email: selmas@nrch.com.au Web: www.nrch.com.au
