Lifeline Aotearoa Volunteer Application
 

 First Name*

 
 
 Last Name*
 
 
 Email Address*
 
 
 Gender*
 
 
 Physical Address*
 
 
 Contact Number*
 
 
 Date of Birth
 
                                                                                                                                               
 Nearest Lifeline Branch
 
 
 Ethnicity*

     Other : 

 
 Do you have a disability that we should be aware of ?*
 (This will help us to provide better support during training and on shift, this will remain confidential to Lifeline Aotearoa)
 
 
 Where did you hear about us ?*
     Other :
 
 Do you agree to the minimum 9 hours per month*
 
 Availability - Days* (This is indicative only. Please select all that apply.)
 
        
 
 Availability - Hours* (This is indicative only. Please select all that apply.)
    
 
 Have you volunteered with Lifeline Aotearoa Before?*  
 Have you volunteered anywhere else before?*(if "Yes" please provide more information)
 
 
 
 Are you a permanent resident of New Zealand*
  If you select other please enter more information:  
 
 Do you agree to paying the $ 100 training fee?*
 
 
 Do you live within 30 mins of the branch location
 
 
 Have you ever been convicted of a Criminal offence?*
 
 
 Are you currently receiving therapy*
 Other :    
 
 If you are in therapy are you able to get a letter from your mental health professional that this would be a suitable role for you?
 
 Do you agree with this statement: I feel that I will be able to solve most of the callers problems
 
 
 Do you agree with this statement: If a caller was feeling sad or depressed its my responsibility to cheer them up
 
 
 Why did you decide to volunteer with Lifeline Aotearoa?
 
 
 What characteristics do you feel you have that suits you for this role?
 
 
 What coping strategies do you use when you are feeling distressed?
 
 
 Please share a quote that sums up your attitude towards life and describe why:
 
 
 Life is full of tests and challenges; please write about something you have learned from a recent challenge in your life.
 
 
 
 Referee 1*(not friends or relatives)
 
 Full Name*
 
 
 Relationship*
 
 
 Contact Number*
 
 
 Best Time to Contact*
    
 
 
 Referee 2* (not friends or relatives)
 
 Full Name*
 
 
 Relationship*
 
 
 Contact Number*
 
 
 Best Time to Contact*
    
 
 Note: Referees will not be contacted until after a successful application interview
 *Required