DanceWize NSW Application Form

Emergency Contact Details

Please provide a contact that you are comfortable knowing you are in this program and will be available to call in case of emergencies.
Emergency Contact *

First NameLast Name
Phone Number*
Please enter a valid phone number.
Emergency Contact Email
example@example.com
Emergency Contact*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Relationship To You*

Qualifications, Licenses and Policies

Please note that none of these are a requirement of becoming a DanceWize volunteer, but if you do have any of the certifications below, it is helpful for us to know.
Allied Based Peer Program
Are you currently a volunteer of an allied peer-based harm reduction program?
DWNSW may be able assist with the costs of First Aid Certification training and Mental Health First Aid Certification Training.

It is not a requirement to have your First Aid certificate (unless you want to be a Team Leader) but it is highly recommended.
Certifications Completed

First AidMental Health First AidCPRWorking With Children Check
WWCC Expiry*

DayMonthYear
Date
WWCC Number*
WWCC (Working With Children's Check)*

Please upload a screenshot of your WWCC (NSW).
Cancelof
First Aid Certification Expiry*

DayMonthYear
Date
First Aid Certificate*

Please upload a screenshot of your First Aid Certificate
Cancelof
CPR Certification Expiry*

DayMonthYear
Date
CPR Certificate*

Please upload a screenshot of your CPR Certificate (if separate from your First Aid Certificate)
Cancelof
Mental Health First Aid Certification Expiry*

DayMonthYear
Date
Mental Health First Aid Certificate*

Please upload a screenshot of your Mental Health First Aid Certificate
Cancelof
DWNSW Signed Volunteer Agreement

Cancelof

Demographics

All information in this section is confidential, and only viewable by DW NSW staff. Information provided may be reported on in a de-identified format.
Pronouns - old
She/Her, He/Him, They/Them or any other
Pronouns
Due to system limitations, if your pronouns are not in the list available, please reach out to us and we can adjust manually.
Gender
Gender refers to current gender, which may be different to sex recorded at birth and may be different to what is indicated on legal documents.
Do you identify as a member of the LGBTQIA+ community?
Do you identify as Aboriginal or Torres Strait Islander?
Languages Spoken
Other than English
Preferences
Dietary Requirements
We do our best to ensure you are provided with a meal for your shift that meets your dietary requirements.It is best to message a Coordinator before your shift advising of any requirements, as well.
Uniform Size

Photography Consent
This would include using photos of you in training, Instagram, Facebook, other DanceWize NSW accounts and materials. If you see a photo you no longer consent to it's your responsibility to contact us so that we can remove the image. You may change your permission and status at any time, however once the photo is in the public domain our ability to remove it is significantly reduced. Please consider this prior to giving consent.
Permission for DW NSW to use photos and images of you in social media and promotional material *

YesNo

To volunteer with DanceWize NSW, you must agree with NUAA and DanceWize NSW Policies and Procedures and the Volunteer Agreement.

NUAA Policies
Volunteer Agreement
I have read and agree to Code of Conduct and Volunteer Agreement*

I agree
Signature*

Clear
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Welcome!