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Laverton Community Integrated Services Inc.
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Volunteer Application Form

"*" indicates required fields

Personal Information:

Prefer Contact Via*

Emergency Contact Details

Type of Work Preferred

Please read the Volunteer Program Brochure for program information that will assist in selecting your preferences, and then tick the appropriate box below.*
What days and times would you like to volunteer?*

Please provide a current reference that we may contact:

Additional Information

Accepted file types: jpg, gif, png, pdf, Max. file size: 1 MB.
*For Volunteer roles at LCIS you are required to undertake a WWCC. It is free for volunteers.
Accepted file types: jpg, gif, png, pdf, Max. file size: 1 MB.
*For Volunteer roles at LCIS you are required to undertake one. This is done at our expense prior to you commencing
Ambulance Subscription
*In the case of an emergency an ambulance will be contacted and associated expenses the responsibility of individual staff/volunteers. Everyone is encouraged to have an ambulance subscription.
Note Indicating a medical condition does not preclude you from Volunteering with LCIS, it simply ensures we place you in an appropriate role and allocate appropriate tasks. We value your health. All medical and personal information will be treated as confidential.
Confidentiality Agreement*
During the time you are a Volunteer at Laverton Community Integrated Services Inc. (LCIS) you may come across information that is deemed confidential or private. This could include personal information about a volunteer, member of the community or staff member. Should this occur, you have a responsibility to respect and maintain the confidentiality and privacy of all organisations and individuals. Breaches of confidentially and/or privacy can in some circumstances constitute offences under the law.
Permission to Use Photographs & Video*
I understand that I may not be suitable for Laverton Community Integrated Services

In order to assist us to match volunteers with areas of need/client requirements, please also provide the following details: