2020 Volunteer Registration Form

Yarra Valley Winter Shelter 2020
Thank you for your willingness to volunteer your time and skills. This project has the potential to make a real difference to those who are without a home and has the long-term goal of journeying with people towards a more stable living situation. We want to offer a comfortable place for rest and refreshment as well as an opportunity to connect with a community who cares and can demonstrate God’s love in practical ways.

Coronavirus (COVID-19)
We endeavour to ensure the safety of all volunteers, staff and guests and are following recommendations of both the Federal Government and the Victoria State Government. Please answer the following questions to ascertain your suitability to proceed with volunteering.
Are you:*
Over 70Over 60 with an ongoing chronic illnessOver 50 and indigenousNone of the above
Please read the following statements carefully:
- I have not been in contact with anyone infected with COVID-19 in the last 14 days or travelled from overseas in the last 14 days
- I am not unwell or displaying symptoms of coronavirus (COVID-19) – fever, breathing difficulties, breathlessness, cough, sore throat, fatigue or tiredness
- I will undertake the specific health and safety training required in relation to COVID-19
- I will alert Stable One immediately if my situation changes and I am no longer eligible under COVID-19 regulations to volunteer.
I agree with and declare that the four statements above are true, and will abide by them:
YesNo
We appreciate your desire to volunteer. At this time, however, we are advised that it is unsafe to accept your application. We will add your name to our mailing list so that you can stay up to date with our activities and look for other ways to get involved. If we still have a need for volunteers when restrictions are amended, we will make our needs known.
Have you volunteered with Stable One before? *
Have you already completed a registration form for 2020?*
Personal Details
Name*
PrefixFirst NameLast Name
Sex*
Address*
Street Address
Street Address Line 2
CityState
Zip Code
Age*
18 - 24 years old25 - 44 years old45 - 64 years old64 +
Phone Number*
Area CodePhone Number
E-mail*
Volunteer Information
How did you hear about the project?
Current Occupation:
Qualifications:
Please enter any post-secondary qualifications
Relevant skills*
Please list any relevant skills or experience. Mention ways you may be able to assist or encourage guests training/upskilling etc) .
In brief, please explain why you would like to volunteer for the Winter Night Shelter Project?*
0/200
Role/s you can fill*
Shift WorkerCook (evening meal)Driver (minibus)No preference
Do you have a food handling certificate?*
YesNo
Do you hold a current first aid certificate? *
Yes - with CPRYes - first aid onlyCPR onlyNo
What level is your certificate?
Please list any medical conditions we should be aware of...
If you attend a church, please name:
Integrity Checks
I consent to undergo integrity checks as listed below*
YesNoI would like more information - please contact me
Working With Children Check (WWCC)
Please confirm that your WWCC is current for this year's project by entering the details below.
Although it is unlikely you will be working with children at the shelter, this is a compulsory requirement for all volunteers.
If you have a current WWCC, please complete the details below. In addition, please go to http://www.workingwithchildren.vic.gov.au/ and update your details by adding Stable One as an associated organisation.
If you do not have a current WWCC, instructions will be provided in an email upon submission of this application.
Reference Check Number
Expiry date
DayMonthYear
If you do not have a check already, do you commit to obtaining one?
YesNo
References
Referee Name*
First NameLast Name
Referee Phone Number*
Area CodePhone Number
Referee E-mail*
Referee type:*
Your referee must not be an immediate family member
If other, please specify
How long have you had this relationship?*
Years
Training and Availability
You will be required to complete an online training course before volunteering commences.
In the table below, please indicate preferred shifts.
Shift Worker Availability
Morning (9am-1pm) Afternoon (1pm-5pm) Evening (6pm-9pm)
Monday 1 2 3
Tuesday 4 5 6
Wednesday 7 8 9
Thursday 10 11 12
Friday 13 14 15
Saturday 16 17 18
Sunday 19 20 21
Driver Availability
Morning Afternoon
Monday 22 23
Tuesday 24 25
Wednesday 26 27
Thursday 28 29
Friday 30 31
Saturday 32 33
Sunday 34 35
Cook availability (evening meal)
MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Please indicate how often you would like to be rostered. Ideally your commitment would be weekly or fortnightly to help simplify the roster. Note any dates unavailable. *
Emergency Contact
Name*
First NameLast Name
Phone Number*
Area CodePhone Number
Relationship to you:
Declaration
I have reviewed and completed this form as applicable to me. I give Stable One permission to verify any information I have provided. This authorisation shall continue to be effective until revoked by me. A copy of this consent shall be as effective as the original. By my initials below, I declare that all information on this form is true and accurate. I consent to my information being stored and used in accordance with Stable One's privacy policy.
My initials here signify that I agree to the terms above:*
Now that you've completed the form & you're about to press 'Submit' (hooray!), please monitor your email inbox for instructions about the next step (you may need to check the junk folder). While we are busy processing your information, we would be grateful if you could go ahead and follow the specific instructions in the confirmation email.
Should be Empty:

	Morning (9am-1pm)	Afternoon (1pm-5pm)	Evening (6pm-9pm)
Monday	1	2	3
Tuesday	4	5	6
Wednesday	7	8	9
Thursday	10	11	12
Friday	13	14	15
Saturday	16	17	18
Sunday	19	20	21

Yarra Valley Winter Shelter 2020

Personal Details

Working With Children Check (WWCC)

References