8 - FORM
8 7-03 VOLUNTEER APPLICATION
You have chosen to help us by donating your time and skills to one of Coast Shelter’s programs. We value your
support and will endeavour to make your time with us rewarding. As one of our team members, you also have
obligations which are set out in Coast Shelter’s Volunteer Handbook. It is important that you take time to
understand the contents of this handbook and feel free to ask any questions you may have.
As a volunteer, if you are required to work unsupervised or in a one-on-one situation with children, you are
required to have a Working with Children clearance which can be obtained at www.kids.nsw.gov.au. In all other
situations, you are encouraged to obtain a Working with Children clearance, although this is not obligatory.
Name:
Date of Birth:
Address:
Home Phone:
Mobile:
Email:
Please provide details of any medical conditions which we may need to be aware of?
Emergency contact:
Relationship to you:
Home Phone:
Mobile:
I have received a copy of Coast Shelter’s Volunteer Handbook and understand its contents?
 Yes
 No
I have provided a copy of the volunteer Working with Children Check clearance letter?
 Yes
 No
I agree to bring the following information to the immediate attention of staff:
 Yes
 Information regarding a crime or intention to commit a crime
 Information or reasonable suspicion where it is believed that a client, staff or volunteer’s
personal safety is in danger e.g. suicide, self-harm or abuse
 Information that indicates a third party would be in danger
 No
I agree to not to discuss or divulge confidential information about clients or staff to any
person outside the Service.
 Yes
 No
I agree to ensure the privacy of clients, employees and other volunteers and will not access
information contained in confidential files.
 Yes
 No
I agree to report all hazards and take reasonable care to ensure the health and safety of
everyone in the workplace.
 Yes
 No
I am aware of Coast Shelter’s Emergency Exit Procedures and the location and operation of
Fire Extinguishers and Blankets.
 Yes
 No
Applicant’s Signature:
Date:
Staff Name:
Signature:
Days available:
 Mon
 Tues
Times available:
 Breakfast
 Wed
 Lunch
 Thurs
 Fri
Date:
 Sat
 Sun
 Dinner
Other notes:
Version: 01-2015
Authorised by: Laurie Maher, Executive Officer Review Date: Jan 2014
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