Volunteer Application Form - Montefiore Home

Volunteer Application Form

Please complete the form below and press the submit button. The Volunteer Manager will contact you to arrange a meeting once it has been received. If you have any questions while completing the form please contact Hazel Stein, Volunteer Manager on (02) 8345 9154 or Jane Silverman, Volunteer and Community Relations Coordinator on (02) 9879 2743.

Personal details

Title *required

First name *required

Surname *required

Street address *required

Suburb *required

State *required

Postcode *required

Phone *required

Mobile phone

Work phone

Email address

Date of birth *required

Preferred facility to work in *required Hunters Hill Woollahra Randwick

Emergency contact details

Name *required

Relationship *required

Phone *required

Alternative phone

Volunteering experience

Have you volunteered previously? *required

If yes please describe below

Have you volunteered at Montefiore previously? *required

If yes please describe

Volunteering availability

Availability *required Monday AM Monday PM Monday evening Tuesday AM Tuesday PM Tuesday evening Wednesday AM Wednesday PM Wednesday evening Thursday AM Thursday PM Thursday evening Friday AM Friday PM Friday evening Saturday AM Saturday PM Saturday evening Sunday AM Sunday PM Sunday evening

Additional comments

Education / work experience / interests

Give brief details below of education and work history

Languages spoken (inc English) *required

Languages written (inc English) *required

Personal and Professional References

1. Name *required

Phone no *required

Relationship *required

2. Name *required

Phone no *required

Relationship *required

Details of any relatives residing in the Home (past or present)

Transport

Do you hold a current driving license? *required

Would you be happy to transport Residents? *required

Do you have your own transport? *required

Car registration number

Do you have comprehensive insurance? *required

Are you licensed to drive a small bus? *required

Preferred area of work

Check as many as you like *required Archives / museum Art therapy Boutique Cafe Computer assistance to Residents Cooking / Baking Crafts Day centre Dementia-specific activities Discussion groups Fete Flower arranging Games - cards, scrabble, quizzes, Rummy tiles etc Gardening Hospital visits Knitting Language groups (Russian / Hebrew etc) Letter writing Library Life stories Manicures Music - singing, playing instruments Nechama-bereavement Outings Personal relationship / visiting one-on-one Planning and assisting in celebrations Poetry group Reading aloud Sewing Shopping Synagogue assistance (Shabbat / Chagim etc) Transport Travel or talks Typing / clerical / administration Welcome guide Other

If 'other' please write what else you can contribute below.

Briefly explain why you have chosen the above

PRIVACY STATEMENT

The Home is governed by a Privacy Policy that supports the privacy and confidentiality of all personal information collected by the Home, subject to the Home’s need to perform its activities and legal obligations. A copy of the Home’s Privacy Policy is available upon request.

Mandatory field(s) marked with *required

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