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Given Name(*)
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Middle Name
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Last Name / Surname(*)
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Street Address
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Suburb(*)
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City(*)
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Post Code
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Email(*)
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Phone (day)
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Phone (night)
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Mobile Phone
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The following demographic information is used for statistical purposes and to help us obtain funding.
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Gender(*)
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Current Educational Institute
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Which ethnicity do you identify with?(*)
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Age band(*)
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Heard of Volunteering Auckland from:(*)
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Labour Force Status(*)
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Transport(*)
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Are you registered with WINZ?(*)
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WINZ - Work and Income New Zealand
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Are you on an income tested benefit?(*)
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If you are a visitor to NZ what kind of visa do you have?
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Visa expiry date
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Please tell us about your availability and what kinds of volunteering you are interested in
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Hours per week available for voluntary work
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How long are you available? (e.g. 3 months, 1 year, etc)
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Preferred Days
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Preferred time of day
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Administration/General Office Roles
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Select 1 or 2 categories that interest you
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Personal Contact Roles
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Select 1 or 2 categories that interest you
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General Duty Roles
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Select 1 or 2 categories that interest you
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Specialised Group Roles
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Select 1 or 2 categories that interest you
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Preferred Location(*)
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Particular goals that you wish to achieve through voluntary activity(*)
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Please choose the two most important goals
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Qualifications and/or training courses achieved/currently studying (please include overseas qualifications)
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Do you have any particular skills, hobbies and/or talents that you wish to use in your voluntary activity ?
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Do you have any health needs that should be given special consideration?
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e.g. Back Pain; on medication; etc
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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.
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I accept(*)
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