Thank you for your interest in the Compassionate Communities Connector Program. Can you please respond to these questions to give us an idea of who you are?  THIS SURVEY CLOSES AT 5 pm ON 25 APRIL 2022.

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* 1. Please complete your name and contact details:

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* 2. Have you ever done voluntary work before?

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* 3. If you answered yes to Q2 please give details

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* 4. Why would you like to volunteer as a Compassionate Communities Connector?

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* 5. What do you hope to gain from volunteering as a Compassionate Communities Connector?

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* 6. What attributes/qualities do you feel you will bring to the role of Compassionate Communities Connector?

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* 7. What experience (if any) do you have of supporting people living with advanced life limiting illness?

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* 8. Have you experienced a significant loss in the last two years? 

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* 9. If you answered yes to Q8,  please give details:

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* 10. Is there anything that might affect your participation as a Compassionate Communities Connector/Volunteer?

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* 11. If you answered yes to Q10 please give details:

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* 12. Do you have any medical conditions/illness that might affect your work as a Compassionate Communities Connector?

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* 13. If you answered yes to Q12 please give details

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* 14. A Compassionate Communities Volunteer needs to be flexible.  Please outline your flexibility and availability here:

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* 15. Are you currently involved in any other community-based organisation?

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* 16. If you answered yes to Q15, please give details.

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