Volunteer Application Form1. Full Name: Mr/Mrs/Ms/Miss/Revd/Dr _____________ __________________________________________

2. Address: ______________________________________________________ ____________________________________________________________________________ 3. Date of Birth: / / (optional)4. Parish/Organisation (if applicable):______________________________________________________5. Phone numbers: Home __________ ____Business _______ _______Mobile ______________ _________

6. E-mail address: ______________________________________________________ _ __________________7. Please indicate type of volunteer work you are willing to do:

Telephone/Reception ( Mailouts ( Word Processing ( Databases ( Research ( Submission writing ( Library ( Promotions ( Maintenance ( Physical/manual tasks ( Other (please specify) _____________________________ __________ 8. Do you have any specific skills/formal qualifications/hobbies that could be relevant?

(e.g. database development, network management, desktop publishing, multi-media, submission writing, marketing/media, lobbying, team leadership experience, fundraising experience, etc. Please list.

___________________________________________________________________ _______________

___________________________________________________________________ _______ _______

9.Do you speak another language? YES ( NO ( Please state: _____________ ___ ____10. When are you available?

Weekdays (please specify day/hours):_____________________

_________________________Only for the following specific date and task: ___________________________ _________________11. Frequency

Daily ( Weekly ( Fortnightly ( Monthly ( Occasional ( Emergency only (12. Do you have any condition that may affect your participation? If so, please provide brief detail:

___________________________________________________________________ ______________________

13. Do you give permission for your name to be added to Anglicare Australias mailing list to receive further information about Anglicare activities? YES ( NO (In offering my services as a volunteer I agree to respect Anglicare Australias ethos, as reflected in its code of ethics and strategic plan. I agree to treat any information obtained whilst working as an Anglicare volunteer as confidential. I give permission for my name to be added to the Anglicare Australia Volunteer database. Should my circumstances change in relation to my volunteer offer, I will advise Anglicare Australias Administration and Network Support Co-ordinator.

Volunteers signature: ________________________________________ Date: _______________ _________

PLEASE FAX BACK THIS FORM TO ANGLICARE AUSTRALIA on (02) 6230 1704 or MAIL to PO Box 4093 ACT 2602 Telephone enquiries: 02 6230 1775 Email: anglicare@anglicare.asn.au