Volunteer Form 2024

Volunteer Form 2024
Name

First NameLast Name
Date of birth

DayMonthYear
Date
Address

Street Address

Street Address Line 2

City

Postal / Zip Code
Which Centre would you like to volunteer at? (Please note you must live locally)*
Please visit for more details https://www.communicare.org.nz/friendship-centres.html
Email
example@example.com
Phone Number

Area CodePhone Number
What is your volunteering experience and skills?
Why do you want to Volunteer?
Do you have any interests that may be relevant to our friendship centres (e.g music, art, fitness etc)?
Health Issues - Please include all dietary / food allergies / medical / cultural and religious restrictions:
Emergency Contact Person
Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
PLEASE NOTE - In signing this Volunteer application form you agree to and acknowledge the following points:

I acknowledge that in the interests of all concerned, all volunteers are required to undergo a NZ Police vetting process and that the results of any such enquiry shall remain strictly confidential between Communicare and the applicant.

I acknowledge that all photographs/film taken during activities held at Communicare or on outings arranged by Communicare remain the property of Communicare and may be used in promotional materials.

While all practicable care will be taken, personal belongings will remain the responsibility of the volunteer.

I confirm that this information is correct, may be kept on file and used for my benefit to contact health professionals, next of kin or caregiver, as necessary.

I understand that an induction will follow, if successful where all processes will be explained, including Health and Safety.
I understand that my position as volunteer will be reviewed annually.

Privacy Statement: The person completing this form agrees to their details being used for the purpose of their role with Communicare. The information will only be accessed by Communicare staff and volunteers for the sole purpose of the delivery of our service. They understand that data will be held securely and will not be distributed to third parties. They have a right to change or access information. They understand that when this information is no longer required for this purpose, official Communicare procedure will be followed to dispose of data.
Please Upload Identification (For example Drivers License / Passport)

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Please Upload a Current Photo of yourself

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Signature

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Date

DayMonthYear
Date
Communicare is fully funded please assist us by responding to ethnicity.

New ZealanderMaoriPacific PeoplesChineseIndianOther AsianOther (Specify)
How did you hear about Communicare?
Confidentiality Agreement

As a volunteer I agree to:
- Abide by and support the philosophy, policy, and guidelines of Communicare CMA.
- Act in the best interests of the organisation
- maintain confidentiality
- Abide by safety and risk management requirements
- Carry out the tasks outlined in the Role Description
- Attend on the agreed time and day or contact the appropriate person if I am not available participate in orientation, meetings, and trainings as required
- Raise any matters of concern with Coordinator
- (For Volunteer Drivers) use a warranted, registered and insured vehicle when driving for the organisation. Notify the organisation of loss of license or driving related charges
The Organisation agrees to:
- Provide information about the organisation
- Provide orientation, support, training and supervision
- Provide a safe working environment
- Provide opportunities for input into the organisational plan and evaluation
- Reimburse for pre-approved expenses
- Acknowledge and recognise the contribution of volunteers to the organisation
Confidentiality Agreement, I First Name Last Name agree, that any information heard, observed or obtained during my work at Communicare CMA Auckland, shall remain confidential to Communicare CMA Auckland.
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Volunteer Form 2024

Emergency Contact Person