Join our volunteer team | Community and Oral Health

Volunteer application form

Required fields are marked with an asterisk (*)

Title:

Personal details*

Are you over 18?*

Yes
No

Phone number*

Email address*

Home address*

Next of Kin (NOK):*

Relationship*

Phone number*

Email address

Are you of Aboriginal or Torres Strait Islander origin?*

No
Yes, Aboriginal
Yes, Torres Strait Islander
Yes, both Aboriginal and Torres Strait Islander

Languages (other than English):

Citizenship/residency status:*

Australian/New Zealand citizen
Australian/New Zealand resident
Holder of working visa
Other visa

Employment status:*

Areas of interest:*

Please tell us about yourself, including your skills, experience and why you are interested in becoming a Community and Oral Health volunteer.

Which days are you available?*

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Number of hours per week?*

2 - 4 hours
5 - 10 hours
10 - 16 hours

Preferred times available to volunteer?*

Morning
Afternoon
Both

Please indicate the preferred location you are interested in:*

Brighton Health Campus
Brighton Residential Aged Care
Brighton Wellness Hub
Ebbtide House – Interim Care unite
Kippa-Ring Residential Aged Care
North Lakes Health Precinct
Red Hill, Halwyn Centre
Zillmere, Residential Transition Care

Please indicate the activities you are interested in:*

Other:

Please specify

Referees:

We require two referees to support your application. A character referee may be anyone apart from a spouse/partner or relative, who has known you personally for at least two years. Your referees may be contacted through the recruitment process.

Referee 1:

Name*

Phone Number*

Email

Relationship to you*

Referee 2:

Name*

Phone Number*

Email

Relationship to you*

Vaccination report:

Due to volunteering in a health service like ours it is important that you, our patients, residents, carers and staff are protected from vaccine-preventable disease. Therefore, it is a condition of volunteering, for all volunteers to provide documentary evidence to verify they have been vaccinated against the following vaccine preventable diseases:

Measles
Mumps
Rubella
Varicella (chicken pox)
Pertussis (whooping cough)
Hepatitis B

Do you agree to provide this evidence?*

Agree
Disagree

Preferred method of contact is:*

Phone
Email

Pre-employment screening

Pre-employment screening, including an Aged Care Criminal History Check will be undertaken on all persons recommended for volunteering services. More information about this national police certificate will be discussed during the next stage of this recruitment process.

Information disclaimer and consent

While Queensland Health endeavours to ensure that the online transmission of the form, containing your information, over the internet is secure, the inherent nature of the internet means that there is a potential risk that your information may be viewed or intercepted by third parties.

Accordingly, submission through the online form shall be at your own risk and Queensland Health accepts no responsibility or liability for any unauthorised access to your information contained in the form when it is submitted online over the internet.

It is inadvisable to complete this form on a public or shared computer. If a public or shared computer is used then this shall be at your own risk, and you must take all reasonable steps to ensure your confidential information does not remain on the computer or in any way accessible by a third party.

Individuals who submit the form online should receive an acknowledgement from Queensland Health that the Form has been sent, on the screen, following submission. Queensland Health accepts no responsibility or liability if this acknowledgement does not appear or we do not receive your online submission.

You acknowledge that you have read and understood Queensland Health’s Privacy Statement and Disclaimer.

I hereby accept and agree to abide by, the above terms and conditions for submitting this Form*

I accept and agree

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