Your Name (required)

Your Address (required)

Date of Birth (required)

Contact phone number (required)

Your Email (required)

Please select your employment status
Full-TimePart-TimeUnemployedRetiredSeeking EmploymentStudentWorkCover

Have you volunteered before? If yes, please give details below.
YesNo

Please enter your previous volunteering experience. Include the Organisation name, the position and the approx dates

Alternatively, you can upload your CV:

Name of the position you are applying for:

Can you speak / write in another language?
YesNo

If yes, which language?

Are you willing to undertake relevant training necessary for you to carry out your volunteer role?
YesNo

MCCSA / Successful Communities is committed to providing an equal opportunity to all applicants and will select volunteers only on the basis of merit for the volunteer position.

Do you have a disability or medical condition that will affect your volunteer work at MCCSA / Successful Communities?
YesNo

If yes, what time of support might you require?

How often are you prepared to volunteer for MCCSA / Successful Communities?
WeeklyFortnightlyMonthlyAs required

How long are you willing to commit to volunteering for MCCSA / Successful Communities?
3 months6 months9 months12 monthsIndefinitely

Please specify what days/times you may be available

If your application to volunteer at MCCSA / Successful Communities is successful, will you be able to provide us with two referees with contact telephone numbers? The referees must be someone you have known longer than two years and not a family member.
YesNo

Are you willing to undertake a National Police Check if required by MCCSA / Successful Communities (at no cost to yourself)?
YesNo

Declaration

I, declare that the information given in this application is true and correct.

I acknowledge that any false or misleading information may lead to my application being rejected or any subsequent approval revoked
I will notify MCCSA / Successful Communities if any of my above circumstances change
I agree that MCCSA / Successful Communities reserves the right to refuse my application.