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* Personal Information

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* Date of Birth (DD/MM/YYYY)

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* What gender do you identify as?

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* Please select any that apply

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* Emergency Contact Details

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* Community Visitor Scheme Volunteer (CVSV) Status

I am a registered Community Visitor Scheme Volunteer

Optional Volunteering Tasks

As a RACF Program volunteer, you will be providing non-clinical social and emotional support to residents in aged care facilities such as:
  • Companionship, social engagement Companionship, social engagement, and conversation
  • Leisure activities - reading, music
  • Providing access and supervision in outdoor spaces
  • Assisting with physical activity and exercise
  • Administration support - answering phones, internal message running, restocking PPE

You also have the option to provide basic grooming and personal care assistance eg. Hair brushing
Please note, this DOES NOT include showering, dressing and toileting.

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* Are you comfortable providing basic grooming and personal care support at this current time

Volunteer Vaccination Requirements

To be a volunteer at a residential aged care facility, it is a mandatory requirement for you to have completed your COVID-19 vaccinations (including booster shot) and Influenza vaccination. Evidence of this will be requested by the aged care facility prior to commencing placement.

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* I am up to date with the following vaccinations

Volunteer National Police Check Requirements

To be a volunteer on this program a National Police Check is required.

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* I have completed a National Police Check in the past 6 months and can provide evidence 

If no, Volunteering SA&NT will support you through the Police Check process and will fully fund this check on your behalf.

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* Volunteer Disclaimer

By providing your personal details to Volunteering SA&NT for the Re-engaging Volunteers into Residential Aged Care Facilities (RACF) Program, you agree that in so doing to the greatest extent that may be permitted by law that Volunteering SA&NT shall have no liability whatsoever to you as result of making such details available to participating organisations for the purpose of this program.

Furthermore, you acknowledge that insofar as you shall be linked with any organisation as part of the Re-engaging Volunteers into RACF Program, that you will make your own assessment to determine whether such organisation and its requirements are appropriate to your needs and skills

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* Privacy Agreement

I consent to Volunteering SA&NT to forward my personal details to participating organisations for the purpose of volunteering for the Re-engaging Volunteers into Residential Aged Care Facilities, and to use the data for subsequent research and statistical analysis. I consent to being contacted by Volunteering SA&NT for participation in future surveys and research

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* Acknowledgement

  • I understand that I am unable to Volunteer for this program without undertaking a National Police Check
  • I understand that I am unable to work as a volunteer for this program without meeting the vaccination requirements in accordance with SA Health and NT Government directives for aged care support service workers
  • I will be able to provide proof of my COVID-19 and Influenza vaccination status when requested by the Aged Care Facility I am placed with
  • I understand that to join the Re-engaging Volunteers into Residential Aged Care Facilities (RACF) Program I will be required to complete online training
  • I understand that my interest in volunteering is based on personal choice and is undertaken freely without the expectation of monetary reward
  • I understand that Volunteering SA&NT acts as a referral agency ONLY and cannot guarantee that any volunteer opportunity will become available as opportunities are SOLELY RELIANT ON the needs of ORGANISATIONS, and will also depend on my availability and location
  • I understand that the information provided by Volunteering SA&NT is limited to that provided by the organisation without being checked or tested

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* Stay up to date

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