COTA Visitors Volunteer Application

This application form should take around 10 minutes to complete and you can save and come back to your application at any time. Please ensure you click “Submit” so that we receive your form.

About You

Name

First Last

Date of Birth

dd-MM-yyyy

Address

Street Address Suburb State Postcode

Phone *

Email

Or list specific times you are available or not available

Please tell us about your life experiences and cultural background (eg. cultural heritage, languages, family, education, employment, volunteering experience)

Please tell us about your hobbies and interests that may be of interest to an older person (eg. travel, music, reading, current affairs, craft, games, activities, puzzles, food, entertainment, technology)

Is there anything else you would like us to know about you, that would help us to meet your needs whilst volunteering? (EG: you may have needs or preferences related to health, culture, language, religion, disability or sexual diversity)

Please list any preferences you have for being matched and visiting an older person (eg. gender, language, culture)

Screening Requirements

Please provide the contact details of two people, other than family or friends, who have agreed to provide a telephone reference for you for the volunteer role that you have applied for.

Please list two people that we can contact by telephone. Please include name, relationship to you, organisation, contact number

THANK YOU

Thank you for taking the time to submit your application to volunteer as a COTA Visitor with COTA SA. We will be in contact with you soon about the next steps. You are welcome to contact us at cvs@cotasa.org.au if you have any questions.

Your information is stored confidentially at COTA SA as per our Privacy Policy.

Enquiry Type *

Enquiry Source

Enquiry Status

COTA Visitors volunteer application form

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