VOLUNTEER APPLICATION FORM


HOSPICE MID CANTERBURY – VOLUNTEER APPLICATION FORM

Please bring your driving licence at the time of interview.
Please bring Second ID as well along with your driving licence at the time of interview.


(Please note that we require consent for police vetting from all applicants. You will be asked to complete this at your interview with the manager of volunteer services.):

If you answered yes, what was the offence and when did it occur: Criminal Conviction Details

Follow Hospice Protocols:

Clients and families involved with Hospice Mid Canterbury are accorded confidentiality. As a volunteer with this organisation, I agree to respect and maintain this trust.
I AGREE to my name and phone number being used within the Hospice. The personal information contained in this form will be held by and remain confidential to the management team of Hospice Mid Canterbury. Under the Privacy Act 1993, I have the right to request access to, and correction of, any of my personal information held by the Hospice. Agreed on Statement of Confidentiality:

I DECLARE THAT all information provided by me in support of my application is correct. I acknowledge that if I have provided incorrect or misleading information or omitted information of significance, or if I fail to notify Hospice Mid Canterbury of changes in the information provided, I may no longer be accepted as a volunteer.
Declaration of Correct Information: