He aha te mea nui i te ao?
He tangata, he tangata, he tangata e
Volunteering
is not a matter of
chance
… it is a matter of
choice!
Ma nga
huruhuru
te manu
ka rere
Y
our
choice
for
volunteering opportunities
Volunteer with your
Head, Heart
and
Hands!
Promoting and Supporting Volunteering to
Individuals, Organisations
and the
Community
Where
Volunteering
Begins
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Individual Registration
[To assist us with your referral please fill in this form as completely as possible]
Given Name
*
Middle Name
Last Name / Surname
*
Contact Address
Street Address
Street Address (cont)
Suburb
City
Postal Code
Email
*
Phone (Day)
Phone(Night)
Cell Phone
Gender
*
Female
Male
Current Educational Institute
- select -
Auckland University of Technology
Manukau Institute of Technology
UNITEC
University of Auckland
Massey University
Auckland International College
Other
Which ethnicity do you identify with?
*
- select -
New Zealander
NZ European
European - Other
Pacific Isles
Australian
Chinese
Indian
Japanese
Korean
Asian - Other
Pakistani
Sri Lankan
North African
South African
North American
South American
United Kingdom
Other
Age Band
*
- select -
10 - 14
15 - 19
20 - 29
30 - 39
40 - 49
50 - 59
60 Plus
Heard of Volunteering Auckland From
*
Agency Referral e.g. CAB
Corporate Programme
Family Member
Friend
Government Dept. e.g.ACC, Work & Income NZ
Local Paper
Notice Board
Pamphlet/Poster
Radio
School/Church
Seminar/Workshop
TV Advert
VA Promotion
Website - Other
Website - VolunteerNow
Other
Labour Force Status
*
- select -
Full-time employed
Part-time employed
Not in Paid Employment by choice
Seeking Employment
Retired
Student
Self employed
Visitor
Other
Transport
- select -
Your own Car available with a Current Driver’s License
Current Driver’s license only
Public Transport e.g. Bus, Train, Taxi
Other
Are you registered with WINZ
(WINZ - Work and Income New Zealand)
Yes
No
Are you on an income-tested benefit?
Yes
No
If you are a visitor to NZ what kind of Visa do you have?
- select -
Working
Student
Visitor
Visa Expires on
(
clear
)
When are you available for Voluntary activity?
Hours Per Week
AM/PM
- select -
AM
PM
FULL DAY
How long are you available ?(eg 3,6,9 months/years etc)
Preferred Days
Mon
Tue
Wed
Thu
Fri
Sat
Sun
What kind of voluntary activity would you like to do? (please tick no more than 4)
Administration / General office-type Roles
Accounting
Administration (General)
Data collection
Data Entry
Filing
Librarian
Newsletter collation
Reception (General)
Secretary
Telephone
Treasurer
Word processing
Other
Personal Contact Roles
Befriending
Budgeting
Child care
Coaching (sport)
Counselling (with training)
Driving (clients)
Entertaining
Family Support (Refugees)
Family Support (other)
Financial Counselling
First Aider
Guiding/Leading groups
Interviewing
Reading / Writing
Tutoring
Visiting (Prison/Individuals)
Other General Duty Roles
Committee member/Trustee
Cooking
Driving (other)
Fundraising
Gardening
Handy person
History (Research)
History (recording)
Information Gathering
Painting
Promotion
Publicity
Repairing
Research
Shopping
Sales (Opportunity Shop)
Tree Planting
Activities for Specialised Group Roles - these generally require the volunteers having specific skills, interests and/or training (usually provided by the organisation)
Animal Care
Arts / Crafts
Dance
Emergency Response
Sports (Indoor)
Sports (outdoor)
Language Instruction
Music (Singing)
Music (Instrument)
Sport (Refereeing, Coaching etc)
Visual Arts (tutoring)
For What Type of Community Organisation Would You Prefer To Volunteer ?
[Please mark no more than TWO]
Animal Welfare
Arts/Cultural/Heritage
Church/Faith
Conservation/Environment
Disability Services
Education
Emergency Services
Health Services (Other)
Information/Advice
Iwi/Maori Services
Migrant/Refugee Services
Older People Services
Overseas Aid
Pacifica Services
Social Justice/Law
Social Services (Other)
Sports/Recreation Services
Youth/Children Services
Volunteer Centre
Preferred Location
North Store
East Auckland
Central Auckland
North Auckland
South Auckland
West Auckland
Manukau
Waitakere
Don't Mind
Particular Goals That You Wish to Achieve Through Your Voluntary Activity?
Community Contribution
Personal Growth
Course/Study Requirement
Help Others
Meet People / New Friends
Enhance Employability
Make a Difference
Its my Duty to Help
Gain new Skills/Knowledge
Share my Skills/Knowledge
Outside Interest
Work Experience
Qualifications and/or training courses achieved / currently studying ? (please include overseas qualifications)
Do you have any particular skills, hobbies and/or talents that you wish to use in your voluntary activity ?
Do you have any health needs that should be given special consideration? [e.g. Back Pain; on Medication; etc]
THE PRIVACY ACT 1993
Volunteering Auckland undertakes to collect, use and store the information provided on this form according to the principles of the Privacy Act 1993. The information will be used by Volunteering Auckland in discussing my referral with the community organisation, also for the community organisation to discuss my referralwith Volunteering Auckland as well as for statistical, funding and administrative purposes within Volunteering Auckland. I understand that final acceptance, orientation, training and placement will be the responsibility of the community organisation to which I am referred as a volunteer.
I accept
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