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Membership Application Form
Organisation name:
Physical address:
Suburb:
City/Town:
Postal address:
Primary contact:
First name:
Last name:
Role:
Email:
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Phone:
Days/times available, and preferred contact method:
Details:
Organisation type:
Charitable Trust
Incorporated Society
Other
Sector:
Please select...
Animals
Arts/Culture/Heritage
Church/Faith
Conservation/Environment
Disability Services
Education
Emergency Services
Health
Information/Advising
Maori Services
Migrant/Refugee Services
Older People Services
Overseas Aid
Pacific Islander Services
Retail
Social Justice
Social Services
Sports/Recreation
Volunteer Centre
Youth/Children
Website:
Charities Commission registration number:
Aim/mission of the organisation, and services provided:
Where did you hear about us?
Health & Safety:
Does your organisation have a current Health and Safety policy and plan?
Yes
No
Will your organisation provide an orientation including a health and safety induction for all referred volunteers?
Yes
No
Does your organisation have a risk schedule that outlines risks and how these risks are mitigated?
Yes
No
Other information: