ACVVS Application Survey Thank you for your interest in the Aged Care Volunteer Visitors Scheme (ACVVS).To find out more about the ACVVS, please visit our website at ACVVS NVSA If you would like to apply to join our Aged Care Volunteer Visitors Scheme (ACVVS), please complete the application survey below. Once your application has been received, our ACVVS Coordinator will contact you to discuss the program in more detail.Please note that background checks are a mandatory requirement for anyone volunteering or working with vulnerable people. Having a previous conviction does not necessarily exclude you from volunteering with us, and we are happy to discuss individual circumstances confidentially.Northern Volunteering SA can cover the cost of a SAPOL National Police Clearance; however, please be aware that processing times can vary and may take between 1–5 weeks.Privacy DisclaimerNorthern Volunteering SA is committed to protecting your privacy. The information collected in this survey is used solely for the purpose of assessing your suitability to volunteer with the Aged Care Volunteer Visitors Scheme (ACVVS) and for ongoing program coordination and communication.Your personal details will be stored securely and will not be shared with any third parties without your consent, except where required by law or for mandatory screening checks (such as police clearances).By completing this survey, you consent to Northern Volunteering SA collecting, storing, and using your information in accordance with our Privacy Policy and relevant legislation.If you have any questions about how your information is handled, please contact us at manager@nvsa.org.au Question Title * 1. Name Question Title * 2. Your email address will be used for all correspondence with your ACVVS Coordinator. This may include meeting arrangements, newsletters, visit forms, training opportunities, and other program-related communications Question Title * 3. Phone Question Title * 4. Date Of Birth D.O.B Date Question Title * 5. Gender Female Male Gender Diverse/Non-Binary Question Title * 6. Residential Address Question Title * 7. Country of Birth Question Title * 8. What language(s) do you speak at home? Question Title * 9. Religion (Optional)We ask this question so we can respectfully match visitors with care recipients who may wish to share conversations about faith or personal beliefs Question Title * 10. Which suburbs would you be willing to visit as an Aged Care Volunteer Visitor Question Title * 11. Would you prefer to visit in an Aged Care Facility or Home Care setting Residential Aged Care Facility Home Care Setting Either Question Title * 12. Are you willing to undergo a National Police Check? Yes No I already have a current in date Clearance Question Title * 13. Will you be able to visit with a recipient for a minimum of one hour once a fortnight Yes No Question Title * 14. Availability Monday Tuesday Wednesday Thursday Friday Saturday Sunday Morning Afternoon Question Title * 15. Are you needing to volunteer to meet Centrelink requirements? Yes No Question Title * 16. Mode of transport you will be using to get to and from volunteering Own car Public transport Other Question Title * 17. Do you have any health limitations that may impact your volunteering role? Yes No Question Title * 18. If you answered yes, please provide details so we can best support you on your volunteering journey Question Title * 19. What motivates you to volunteer as an Aged Care Volunteer Visitor? Question Title * 20. Please provide the names and details of two referee and their relationship to you - please note that family members or partners cannot be referees Name Email Phone Number Relationship to you Name Email Phone Number Relationship to you Question Title * 21. Please provide the name and contact details of an emergency contact Question Title * 22. Please tick to indicate that the information you have provided is correct The information I have provided is correct Done
