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Northside Multicultural Community INC

e: northsidemulticultural@gmail.com
m: 0406 874 650

VOLUNTEER APPLICATION FORM

NAME: .............................................................................................................................................

ADDRESS: .............................................................................................................................................

......................................................................POSTCODE: ................................................

TELEPHONE: (Home)....................................(Work).............................. (Mobile)..................................


EMAIL: ..........................................................................................................................................

EMERGENCY CONTACT:

Name: _______________________________________________ Phone: ____________________________

Address: ________________________________________________________________________________

______________________________________________________________ Postcode: _______________

Do you have a Blue Card?

YES  Card must be sighted by the NMC staff.

NO  You are required to apply for a Blue Card before you can commence volunteering at the
centre.

Skills I Have: ________________________________________________________________________________

_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

I wish to assist the organization by _________________________________________

________________________________________________________________________________

Signature: ___________________________________________ Date: _______________________

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OFFICE USE ONLY
Date Rec’d: _______________________ By Whom: ___________________________________________________________

Volunteer Activity: ________________________________________________________________________________________

Commencing: ___________________________________________________________________________________________

Has Blue Card been sighted?

nt has no card, an application form must be filled out.

Has Blue Card application form been completed? Yes / No

Permission to use photographs and materials for publicity and fund raising for
the organization.

I .............................................................. give permission to the Northside Multicultural


Community Inc to use images of me and materials (of a non-personal nature)
supplied by me, as part of their promotional and fund raising activities for the
organization.

Confidentiality
I …………………………………………………..will preserve confidentiality of any
information from the organisations documents, verbal communication, or from any other
source which relate to the organisations business, staff or clients.

APPLICANT'S SIGNATURE: ............................................................ DATE: ........./............/............

___________________________________________________________________________________

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