Volunteer Form

Please complete the form and press send at the bottom to submit your information to Council.

Applicant Details

Name (required)

Postal Address(required)

Town/City

Daytime Phone:

Email (required)

Have you previously volunteered with Lithgow City Council?
YesNo

Are you subject to the Centrelink Mutual Obligation requirement?
YesNo

Do you hold a current drivers licence?
YesNo

Do you hold a current white card?
YesNo


Emergency Contact
As this form also collects the personal information of an individual you have nominated as your emergency contact, under Lithgow City Council privacy obligations, you are required to obtain the consent of the nominated individuals for the collection of their personal information in this form.

Emergency Contact Name:

Relationship to you:

Daytime Contact Number:


Employment Status
Please select your employment status (select more than one if applicable)
FulltimePartimeStudyingUnemployedRetiredCurrently Volunteering


Availability

Please indicate when you are available for volunteer work (select more than one if applicable)
WeekdaysWeekendsPublic HolidaysEvenings


Work Areas
Please select your preferred area/s of work:
Art GalleryEventsMuseum355 CommitteeEnvironmentTourismCommunity & CultureBushcare GroupLibrariesSport & recreation


Supporting Information

Please supply the name and contact phone number for two referees. *

Referee Number 1

Name:

Phone:

Referee Number 2

Name:

Phone:

Are you a registered NSW volunteer?
YesNo

What made you decide to volunteer?

Health and fitness: Please provide details of any disabilities, medical conditions or allergies that we should be aware of:


Skills and abilities

Please list any skills and abilities you have in any of the areas below. Include information even if you think it may not be relevant – you never know what might be useful.

Formal qualifications

Languages

Business administration

Computer skills

First aid

Cash handling

Public speaking

Hospitality

Marketing

Teaching

Research

The Arts

Trades

Museums:

Tourism:

Events:

Libraries

Garden/Environmental Activities:

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