Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Other Phone (optional)

(###)

###

####

Annual Membership Fee *

$10 Annually

Membership *

Women Illawarra Inc. is a community-based organisation run by women for women in the Illawarra. 1. Applications for membership of the Association will be referred to the Board for approval. The Board is not required to supply reasons for accepting or rejecting an application for membership. 2. A member of the Association must, on admission to membership, pay to the Association an annual membership fee as listed on the membership application form. This must be paid within the period of 28 days of membership approval. Payment can be made via PayPal on the Women Illawarra website, or via direct deposit – details will be provided. 3. The applicant’s name will be added to the Women Illawarra Membership Register when they then become a member of the Association. 4. The Board may, by resolution, discipline, suspend or expel a member from membership of the Association if it is warranted. By checking the box below, you indicate that you are aware of the aims of the association and subscribe to them.

I agree to the terms above and I wish to become a member of Women Illawarra Inc.

Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Other Phone (optional)

(###)

###

####

Licence Expiry Date

MM

DD

YYYY

Start Date *

MM

DD

YYYY

Preferred Days *

Monday AM

Monday PM

Tuesday AM

Tuesday PM

Wednesday AM

Wednesday PM

Thursday AM

Thursday PM

Friday AM

Friday PM

Saturday AM

Saturday PM

Sunday AM

Sunday PM

Referee 1: Name *

First Name

Last Name

Referee 1: Phone *

(###)

###

####

Referee 2: Name

First Name

Last Name

Referee 2: Phone

(###)

###

####

WWCC Expiry Date

MM

DD

YYYY

Are you aware of any circumstances regarding your health or capacity (illness, injury, medication, etc) to volunteer that would impact you performing the duties of the role or for which you may require support or adjustments? *

Yes

No

Do you identify as an Aboriginal and/or Torres Strait Islander person? *

Aboriginal

Torres Strait Islander

Aboriginal and Torres Strait Islander

Prefer not to answer

None of the above

Do you identify as being from a Culturally and Linguistically Diverse (CALD) background? *

Yes

No

Prefer not to answer

Emergency Contact 1: Name *

First Name

Last Name

Emergency Contact 1: Phone *

(###)

###

####

Emergency Contact 2: Name

First Name

Last Name

Emergency Contact 2: Phone

(###)

###

####

Application Declaration *

By completing this application, you acknowledge and accept to observe and respect all policies, procedures, terms and conditions of volunteering, including information provided during your orientation: 1. I am applying for a role as Volunteer with Women Illawarra Incorporated. 2. I agree to act in a way consistent with the Vision of Women Illawarra. 3. I agree to comply with the policies and procedures of the organisation, including Women Illawarra’s Code of Conduct. 4. I will comply with all reasonable direction by the worker/s delegated to supervise my volunteering activities. 5. I agree not to disclose any confidential information about Women Illawarra, including social media platforms, unless specifically authorised by Women Illawarra, or compelled by law. I understand this confidential material includes, but is not limited to, details about the organisation’s employees, members, board, volunteers, donors, clients, participants or people assisted by the organisation. 6. I understand that I am required to participate in an interview and undertake a reference and background check. 7. I understand that I am required to read and sign policies applicable to being a volunteer with Women Illawarra. 8. I will abide by the Work, Health and Safety procedures, both organisational and as required by the volunteering role, which may include wearing personal protective equipment provided by management. 9. I will advise my supervisor of any changes to my health or capacity that may affect my ability to perform in my role, for example illness, medication or injury.

I agree to the terms above and I wish to become a volunteer for Women Illawarra Inc.