Student Volunteer Application Form

Please complete the form below and press the submit button. The Volunteer Manager/Coordinator will contact you to arrange a meeting once it has been received. If you have any questions while completing the form please contact Hazel Stein, Volunteer Manager on 02 8345 9154, or Jane Silverman, Volunteer Coordinator on 02 9879 2743

Personal Details

First Name

Surname

Date of birth

Email address

Street Address

Suburb

State

Postcode

Mobile Number

Phone number

Name of school attending

Year at school

Emergency contact name

Emergency contact number

Relationship of emergency contact

Volunteering Experience

Have you any previous volunteering experience?

If 'Yes', please describe

Have you previously volunteered at Montefiore?

If 'Yes', please describe

Medical History

Any allergies

Any other conditions we should be aware of

Availability

Monday (pm)	Tuesday (pm)
Wednesday (pm)	Thursday (pm)
Friday (pm)	Saturday (am)
Sunday (pm)

Preferred facility to work in

Multiple choice, press Ctrl to select

Skills/Areas of Interest

Bingo Caller	Chatting to residents
Games - cards, scrabble, quizzes, rummy tiles, etc	Language Groups - Russian, French, Yiddish, Hebrew, etc
Music - singing, playing instruments, etc	Personal Friendship
Reading to Residents	Shabbat on wheels
Synagogue assistance - Shabbat, Chagim, etc	Ushering
Walking Program

Other (area of interest)

Why have you chosen the above areas of interest?

Reason for volunteering

multiple choice, press Ctrl to select

Community involvement hours (school)

Commitment

Please print and ask your parent to sign the volunteer guide and photo permission form . Bring this to the interview.

Please read the code of conduct before submitting the form.

PRIVACY STATEMENT

The Home is governed by a Privacy Policy that supports the privacy and confidentiality of all personal information collected by the Home, subject to the Home’s need to perform its activities and legal obligations. A copy of the Home’s Privacy Policy is available upon request.

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Contact Information