Volunteer Position

AVAILABILITY FORM VOLUNTEER POSITION

Volunteer Position Details

Position: (select as appropriate)  Volunteer Case Worker  Volunteer Community Support Worker  Volunteer Project Worker  Volunteer Administration Officer  Event Volunteer  Volunteer Retail Assistant Organisation:  DAA  MHAA  ACCS Date: Location(s):

Applicant Details Title First Name Middle Name(s) Surname

Preferred Name: Date of Birth: Home Ph.: ( ) Work Ph.: ( ) Mobile: Email: Preferred method of contact:  Home Ph.  Work Ph.  Mobile  Email Preferred time: Between : AM / PM and : AM / PM On  Monday  Tuesday  Wednesday  Thursday  Friday

Are you volunteering in order to complete a required  No  Yes Placement (practicum) or Internship? If ‘Yes’ please provide details of required number of days per week below. NOTES: Available shifts and frequency of shifts will be dependent on the program you will be engaged in during your service as a volunteer. Please be aware you may not always get your first choice. Not all programs operate all days of the week – consult the website and/or the program staff for operating hours.

Availability (please indicate all days you are available) Day Mon Tues Wed Thurs Fri Sat Sun First (1st) Preference       

Second (2nd) Preference       

Third (3rd) Preference       

Frequency of shifts? (tick one only)  Weekly  Fortnightly  Monthly

Comments / Additional Information Please use the space provided to provide any extra detail that may be useful for program staff responsible for rostering volunteers.

Applicant Signature: Date:

Completed forms can be returned to the organisation by: QLD Fax: (07) 3392 9846 Mail: GPO Box 590 BRISBANE QLD 4001 NSW Fax: (02) 9755 0593 OR Mail: PO Box 1030 FAIRFIELD NSW 1860 OR Email: [email protected] SA Fax: (08) 8358 2921 Mail: PO Box 1 OAKLANDS PARK SA 5046

No.: HR-006/53 Issue:1 Date: 30.07.13 Page 1 of 1