Highlands Community Hospice Service Volunteer Application Form

Highlands Community Hospice Service

Volunteer Application Form

Highlands is seeking dedicated volunteers to support our community volunteer hospice service. We are building a diverse and compassionate community that brings together individuals with unique skills and life experiences to provide meaningful support to those nearing the end of their lives and their carers.

We are committed to matching volunteers with roles that align with their skills, experience and interests, and the specific needs of our hospice service. Information collected will assist us to assess applicant suitability, understand your strengths and capabilities, and help match you with volunteer opportunities and clients.

If you are passionate about making a difference in end-of-life care and have skills to contribute, we encourage you to apply and become part of our compassionate community hospice service.

For more information and to see the position description, please go to our website, click here or paste in your browser: www.highlandsendoflifeproject.com.au/hospice

Contact Details

Name

Preferred Name

Email*

example@example.com

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

City / Town

Postcode

Date of Birth

Date

Emergency contact person

First NameLast Name

Emergency contact phone number

Area CodePhone Number

Information

Please tell us why you are interested in volunteering with Highlands Community Hospice Service?

What skills and experience will you bring to your volunteer role?

Do you have any hobbies or interests that you feel to share? This helps us when matching volunteers with clients.

Please list any experience as a volunteer - for example, the name of organisation, duration and brief description of your role.

Current Employment Status

Cultural Background

Do you identify as Aboriginal or Torres Strait Islander?

Languages spoken in addition to English

Languages written in addition to English

Health

We have a duty of care to protect your health and wellbeing while you are a volunteer. Your answers to the following questions will assist this process.

Do you have an existing medical disability / condition / injury including underlying chronic physical or mental health conditions that my impact on your ability to perform volunteer duties?

YesNo

If yes, please provide details and any adjustments we can make to accommodate.

Have you been bereaved in the past year?

YesNo

If yes, please provide some details.

Volunteering Preferences

What type of volunteer work are you interested in? Please tick one or more options below. Please refer to the Position and Program Descriptions for more information.

Companionship and connection with the client and/ or caregivers e.g. conversations, going for outings, time in nature, engaging in music, art or other hobbiesHome help - assistance in the homeAppointments - assistance with appointments, shopping and errandsRespite care - support for primary carerLegacy projects - for example biography writing, sorting photos, writing letters or helping with unfinished art and craft projectsHelping care for petsGardeningFundraising or other organisational support like assisting with social media, resource development, help with events, being on a committee etc.

Further details about volunteering preferences

Which days are you available to volunteer?

How many hours per week would you be available to volunteer?

Preferred hours

MorningAfternoonEveningFlexible

Preferred volunteering location

Armidale areaUralla areaGuyra areaWalcha area

Are you willing to undertake initial and ongoing Volunteer Training as required and provided by our service?

YesNo

Please specify which days and times suit you best to attend training sessions.

Licenses and Checks

Do you have a Drivers’ License?

YesNo

If you own a motor vehicle, is it comprehensively insured?

YesNo

Do you have a current First Aid Certificate?

YesNo

Do you agree to complete a Police Record Check?

YesNo

Do you currently have or agree to complete a Working with Children Check?

YesNo

Please provide the names and details for two referees

Referee Number 1

Referee Number 2

Additional Information

Is there anything else you would like to tell us to support your application?

Applicant Agreement

I have read the Highlands Community Hospice Service Program Description, Position Description and the Training and Development documents.
I confirm that all information contained in this application form is true and complete.
I understand that any false statement or the withholding of information may cancel my application to become a volunteer with the Highlands Community Hospice Service.
I understand that if my application is successful and I am accepted into the volunteer program, I am required to adhere to organisational and program policies, procedures and guidelines.

Thank you for taking the time to complete this application, we will be in touch.

Warm regards,

The Highlands Team.