Section 1 - Applicant Personal Information:

First Name:

Family Name:

Home Phone:

Mobile Phone:

Work Phone:

Facebook Address:

Email Address:

Date of Birth:

Gender:

FemaleMale

:

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:

Next of Kin Details

:

This person will be contacted in any EMERGENCY situation

Name:

Relationship:

Contact no:

Email Address:

:

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Associated Lasallian School:

Current Occupation:

Citizenship:

Do you hold a current passport?:

YesNo

Passport number:

Passport Expiry Date:

Country of issue:

Do you hold a current driver's licence?:

YesNo

Driver's Licence Country/State of Issue:

Medicare Number:

Australian Tax File Number:

Working With Children or Police Check Number:

Working With Children or Police Check Issuing Authority:

Apply for your Working With Children Check and/or Police Check:

NSW: https://wwccheck.ccyp.nsw.gov.au/Applicants/Application

QLD: https://www.bluecard.qld.gov.au/volunteers/howdoiapply.html

WA: https://workingwithchildren.wa.gov.au/applicants-card-holders/applying-for-a-wwc-check/how-to-apply

NZ: https://www.justice.govt.nz/criminal-records/

AUST: https://www.afp.gov.au/what-we-do/services/criminal-records/national-police-checks

PNG: https://evisa.ica.gov.pg/evisa/account/Apply

First Aid Certification (required):

Other current relevant qualifications (eg Bronze medallion):

Section 2 - Applicant Health Information:

Please select the ONE item that best describes your present physical health:

in excellent health, fine physical conditionin normal, good healthin fair health, occasionally unwellin somewhat poor health, sick regularlycoping with some illness, under medical supervision

Do you have any pre-existing medical conditions of which we should be aware of? (If yes, please outline):

Please select the ONE item that best describes your present mental health:

I generally feel pretty good about myself and othersI generally feel energetic, enthusiastic about myself and othersI have my ups and downs but am ordinarily in fairly good balanceI seem to be under constant stress, too much to do & not enough time to do itI usually feel somewhat down on myself and/or others, depressed

Do you suffer, or have you ever suffered, from a mental illness? If so, please outline your condition and any current medications you may be taking:

If the answer was Yes to the above question, did you seek professional assistance? Are you still seeking assistance, if not, what strategies do you have in place to assist you?:

List any physical limitations and/or disabilities you may have:

Do you have any special dietary needs and/or allergies:

YesNo

If YES please list:

Are you allergic to any medications, environmental conditions, etc?:

YesNo

If YES please list:

Please indicate any other issues of which the program organisers should be aware:

What kind of support do you think you would need if you were a successful applicant?:

Section 3 - Applicant Profile Information:

:

Please answer the following questions in as much detail as possible

Why do you wish to join this Lasallian Volunteers program?:

How would your friends and family describe your personality?:

What does 'being Lasallian' mean to you?:

What involvement have you had in school &/or post school Lasallian activities i.e. Camp La Salle, Lasallian Youth Leader, etc?:

Do you have any previous experience as a volunteer? If yes - please describe:

Please list any special skills and qualifications you have acquired / developed through previous employment(s), volunteer work, ministry experience or other activities eg sports, that you could utilise as a member of this Lasallian Volunteers program:

Please explain as detailed as possible why you want to be part of the LASALLIAN VOLUNTEER Program::

Section 4 - Applicant Referee Information:

It is essential that all volunteers are well supported in their choices, for the volunteer and the program to mutually flourish. To ensure we are balanced in our decisions we need to know about you and your motivation to volunteer. Please upload two written references and one referee to be phoned. Nominate one referee/written reference from each of the three areas for us to contact to support your application to join the Lasallian Volunteer program. Your nominated referees should be people who know you well and willingly support your decision to enter this commitment.

:

Referee 1: Church and/or Lasallian contact (Spiritual)

Name:

Relationship:

Reference Type:

WrittenPhone

Work/Mobile Phone:

Home Phone:

:

Referee 2: Employer / Supervisor of Voluntary work (Professional)

Name:

Relationship:

Reference Type:

WrittenPhone

Work/Mobile Phone:

Home Phone:

:

Referee 3: Family member / Friend (Character)

Name:

Relationship:

Reference Type:

WrittenPhone

Work/Mobile Phone:

Home Phone:

:

Your referee must address the following items in their written reference:

:

● How long have you known the applicant and in what capacity?

:

● Please describe your experience of the applicant interacting with a variety of ages ranges

:

● Please describe an experience in which you have seen the applicant respond to challenges

:

● Please give an example of the applicant completing a project. What did they do in that process?

:

● As a potential Lasallian Volunteer who would work for one year in possibly a remote location - assisting in the school with specified tasks, where they build relationships with young people - What else would you like us to know about the applicant?

Section 5 - Educational / Professional History:

:

Please answer the following questions in as much detail as possible

:

A. Please give a brief educational / professional history (e.g. Year 11 / 12 Trial exam results, certificates, diplomas, degrees etc)

Educational Institution:

Year/s:

Course:

Year completed / Length:

:

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Educational Institution:

Year/s:

Course:

Year completed / Length:

:

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Educational Institution:

Year/s:

Course:

Year completed / Length:

:

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Educational Institution:

Year/s:

Course:

Year completed / Length:

:

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Educational Institution:

Year/s:

Course:

Year completed / Length:

:

If you have further educational/professional history to add, please upload it here.

:

B. Please list your employment history

Business / Company Name:

Year/s or months:

Type of Work:

:

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Business / Company Name:

Year/s or months:

Type of Work:

:

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Business / Company Name:

Year/s or months:

Type of Work:

:

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Business / Company Name:

Year/s or months:

Type of Work:

:

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Business / Company Name:

Year/s or months:

Type of Work:

:

If you have further employment history to add, please upload it here.

Section 6 - Pastoral Information:

What type of experience are you interested in and why? (e.g. assistance in social welfare, trade work, youth ministry, sports, computers, counselling, teaching, outdoor education, classroom assistance, special education etc.) Please explain.:

2. Is there any LASALLIAN VOLUNTEER Program placement / location you are attracted to and why?:

Please list your preferred placement locations (numbered in order of preference 1-5):

:

Please list your preferences for placement location:

1:

2:

3:

4:

5:

5a. Where have you travelled previously?:

Length of time:

Capacity:

5b. Where have you travelled previously?:

Length of time:

Capacity:

Is there anything else you would like to write concerning your application?:

:

Applicant Agreement

:

By submitting this application, I affirm that the information included herein is true and complete. I understand that if I am successful in gaining a position on a Lasallian Volunteer program, any false statements, omissions, and / or other misrepresentations made by me in this application may result in my immediate dismissal from the program.

Name:

Date:

Spam Verification:

Email Address

Please tick to verify that you are not a robot

Lasallian Volunteers 2021

Long Term Program

Application Form 2021
PROGRAM DATES: 15/01/21 to 05/12/21

2021 Long Term Program Application

Next of Kin Details

Referee 1: Church and/or Lasallian contact (Spiritual)

Referee 2: Employer / Supervisor of Voluntary work (Professional)

Referee 3: Family member / Friend (Character)

Your referee must address the following items in their written reference:

A. Please give a brief educational / professional history (e.g. Year 11 / 12 Trial exam results, certificates, diplomas, degrees etc)

B. Please list your employment history

Applicant Agreement

ABOUT US

SCHOOLS AND MINISTRIES

FORMATION

YOUNG LASALLIANS

Policies

VOCATION

RESOURCES

Lasallian Volunteers 2021

Long Term Program

Application Form 2021 PROGRAM DATES: 15/01/21 to 05/12/21

2021 Long Term Program Application

Next of Kin Details

Referee 1: Church and/or Lasallian contact (Spiritual)

Referee 2: Employer / Supervisor of Voluntary work (Professional)

Referee 3: Family member / Friend (Character)

Your referee must address the following items in their written reference:

A. Please give a brief educational / professional history (e.g. Year 11 / 12 Trial exam results, certificates, diplomas, degrees etc)

B. Please list your employment history

Applicant Agreement

ABOUT US

SCHOOLS AND MINISTRIES

FORMATION

YOUNG LASALLIANS

Policies

VOCATION

RESOURCES

Application Form 2021
PROGRAM DATES: 15/01/21 to 05/12/21