COVID-19 Volunteer registration

To register as a potential COVID-19 volunteer with us, please fill in the form below. Fields marked with * are required. If you wish to sign up as a general volunteer - please click here.

Details
First name: *
Last name: *
Phone: *
Email: *
Address: *
Age band: *
10-14
15-19
20-29
30-39
40-49
50-59
60-69
70 & over
COVID19 details
Have you returned to New Zealand from Overseas since the 16th March 2020? : *
Yes
No
Have you been unwell? : *
Yes
No
Police Vetting
Have you been Police vetted or Police Checked? *
Yes
No
Volunteering
Are you currently volunteering for any community organisations?: *
Yes
No
Referees
Please provide contact details of TWO Referees of known people, ie Employer, Church Minister, or similar and their connection to you: *
Preferences
Availability:
AMPM
EveningsNo preferences
Day(s):
MondayTuesday
WednesdayThursday
FridaySaturday
Sunday
Select all days
Preferred Area(s):
Bell BlockEltham
HaweraInglewood
New PlymouthOakura
OkatoOpunake
PateaStratford
UrenuiWaitara
Waverley
Transport
Your own car available? : *
Yes
No
Current driver licence? : *
Yes - please upload your current driver licence (front and back)
No
Front image of licence:
only small jpg files allowed
Back image of licence:
only jpg files allowed
Skills and info
Do you have any particular skills, hobbies and/or talents that you wish to use in your voluntary activity:
Do you have any other information you wish to share with us to assist in your referral:

PRIVACY ACT
Volunteering New Plymouth 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 New Plymouth in discussing my referral with the community organisation, also for the community organisation to discuss my referral with the Volunteering New Plymouth as well as for statistical, funding and administrative purposes within Volunteering New Plymouth. 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.

By registering with Volunteering New Plymouth I agree to:

  1. Giving permission for my referees to be contacted for reference checks
  2. Agree that I will adhere to the principles of the Privacy Act 1993 when volunteering for an Organisation I am referred to.
  3. When accepted to a volunteer role I agree to adhering to the Health & Safety requirements of that Organisation

I agree to the terms and conditions *