Family Name

Given Name

Other Names

Preferred Full Name

Sex Male
Female

Date of Birth

Principal Email Address

Re-enter Principal Email Address

Alternative Email Address

Mobile or Other Primary Telephone Number

Alternative Telephone Number

I am a NSW Public Servant/Public Sector employee

Home Department/Agency

Position

Employee Number

Supervisor/Manager Name

Work Telephone Number

Work Email Address

Street Address/PO Box

Suburb

Postcode

State ACT
NSW
NT
QLD
SA
TAS
VIC
WA

Please click if your street address is different to your mailing address above

Street Address

Suburb

Postcode

State ACT
NSW
NT
QLD
SA
TAS
VIC
WA

Have you volunteered for an event or organisation previously? Yes
No

If yes, please specify below

Please state why you would like to be a WYDCA Volunteer?

What languages other than English do you speak?

Are you of Aboriginal and/or Torres Strait Islander origin? Yes
No

Please list any experience or qualifications you have that may be of relevance as a WYDCA Volunteer

Please list any experience you have working in a supervisory capacity

For the purposes of work role and location placement, please provide details of any disability or medical condition that could affect where you work and the roles you could perform

I am available to work at least three (3) shifts between Tuesday 15 July 2008 and Sunday 20 July 2008. Please note that an average shift will be approximately eight hours in duration and that shifts will commence in the morning or afternoon.

Please indicate the maximum number of shifts you are available for? 3 shifts
4 shifts
5 shifts
6 shifts

Please tick any dates during the event period when you are not available to work: Tuesday 15 July
Wednesday 16 July
Thursday 17 July
Friday 18 July
Saturday 19 July
Sunday 20 July

Given the nature of the event, some shifts on the weekend of Saturday 19 July to Sunday 20 July may involve early morning starts (from 5:00 am) and late night finishes (up to 12:30 am). Please indicate below if you are able to assist with one or more of these shifts. Saturday 19 July - early morning
Saturday 19 July - late night
Sunday 20 July - early morning
Sunday 20 July - late night

Are you an Australian Citizen or Permanent Resident? Yes
No

If no, please specify what type of Visa you hold

Do you agree to your details being forwarded (at the discretion of WYDCA) to other NSW government departments/agencies or statutory authorities for the purposes of being contacted in relation to future volunteering opportunities in relation to major events? Yes
No

I understand that if I am successful in my application to be a volunteer, I may be subject to criminal record and working with children background checks. If necessary, WYDCA would conduct these checks after obtaining my consent and at no cost to me.

Many volunteer positions will involve two people working together. Please indicate if you would like to be paired with a friend/colleague.

Name of friend/colleague

Email Address of friend/colleague

Name/Next of Kin

Relationship to you

Home Telephone

Work Telephone

Mobile Telephone

How did you hear about the WYDCA Volunteer Program? Circular No. 2008 - 07
Email from my Department/Agency
Flyer
NSW Public Sector Notices
WYDCA website
Friend/colleague
Other

Other (Please Specify)