Your full name

Email address

Phone

Birthday

Residential Address

How did you hear about us?

Emergency contact details

Name

Email address

Phone

Relationship to you

Residential Address

Do you have any allergies/medical conditions that we should be aware of?
YesNo

If yes, please detail:

Your experience, skills and abilities

What work experience do you have or what are your key skills?

What skills would you like to develop?

Do you have any of the following?
Driver's licence (C)National Police CertificateWorking with Children check

Are you able to do manual/heavy lifting?
YesNo

Have you read the Volunteer and induction handbook?
YesNo

Have you completed module 1 and one other module on the Cfsmart website?
YesNo

Confidentiality agreement

I hereby agree that I will not in any capacity, be it verbal, written or in any form of electronic communication, disclose to any person outside Cystic Fibrosis Queensland ( CFQ) any information in relation to CFQ, CFQ clients and their families. I understand that the only exception to this is where in the course of my duties I am authorised to disclose information that is essential to the health and welfare of a client. Any breach of this confidentiality agreement may result in a review of my volunteering arrangements.
Yes, I accept the above terms of the confidentiality agreement