Volunteer Individual Application Form

Required fields are marked with an asterisk (*).

The following information is needed to ensure that we cover you under our insurance policy and offer you appropriate support services

Contact Details
Enter your mobile number without spaces
Enter your mobile number without spaces
Enter your mobile number without spaces
Enter your postcode without spaces
Medical Information
Do you have a current First Aid Certificate? *
Do you have a current Department for Human Services Working with Children Screening Clearance? *
Do you have any medical problems or are you taking any medication which may affect your volunteering? *
Contact Person for Emergencies
Volunteer Preferences

It would be appreciated if you could supply the following information:

Skills and Experience
Please List:

It is Council policy to check references of all new Volunteers. Please provide details below:
(two referees, one business and one personal)

Business Referee
Personal Referee

Other Comments

Please note that Council's indemnifier does not cover any person under the age of 10 or over the age of 90. Also any person that does not hold an Australian Medicare Card is also not covered by Council’s insurance policy for volunteers.

Port Augusta City Council Privacy Policy

Any personal details collected will be used only for the purpose of processing your registration, keeping records, and establishing your identity. The supply of information by you is voluntary. If you cannot provide or do not wish to provide the information sought, the Council may not be able to process your application. Access to the information is restricted to Council officers and other authorised people. Council is to be regarded as the agency that holds the information. You may make an application for access or amendment to information held by Council.