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

Firstname

Surname

Mobile Enter your mobile number without spaces

Home phone Enter your mobile number without spaces

Work phone Enter your mobile number without spaces

Address line 1

Address line 2

Postcode Enter your postcode without spaces

Suburb

Medical Information

Title

Age Group

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

Title

Given Names *

Surname *

Relationship to Volunteer *

Home

Business

Mobile

Volunteer Preferences

Which Council Program would you like to join? What day(s) would suit you to volunteer in the program? *

How did you hear about the (Council's Volunteer Program)?

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

Skills and Experience

Do you have any experience in Volunteering before?

Do you have expertise in a particular field which you may like to share through volunteering? 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

Title

Given Names

Surname

Company

Home Phone

Business Phone

Mobile

Relationship to Applicant

Personal Referee

Title

Given Names

Surname

Home Phone

Business Phone

Mobile

Relationship to Applicant

Other Comments

Insurance

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.