Volunteer Application Form: Volunteer Application Form: The Cafe 1 2 3 4 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 e.g. barista skills, sandwich making* Why would you like to volunteer at The Cafe at North Richmond Community Health (NRCH)?*Which day/s would you like to volunteer at The Cafe? The Cafe hours are 9:30 am - 1:30 pm* Monday Tuesday Wednesday Thursday Friday 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 How did you find out about The Cafe ?*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.Do you have a current Working With Children's Check?* Yes No Do you consent to a Police Check?*If you have a Police Check conducted within the last 3 years, you can provide this at your interview. Yes No I can provide a recent Police Check 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 that: the information I have provided in this form is true and correct AND I have read and understood The Cafe Volunteer Position Description 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
