Volunteer Application Form
Kia Ora. Thank you for your interest in Volunteering with Blind Low Vision NZ. To enable us to understand your skills and offer you an appropriate role, please complete all details in this application form below
Prerequisites
From 1 December 2021 all employees, volunteers and contractors working on behalf of Blind Low Vision NZ will need to provide acceptable proof of full Covid-19 vaccination status before engaging with our clients or entering Blind Low Vision NZ offices or worksites. In order to be considered for a Volunteer role, you will need to provide proof accordingly.
I understand
Are you fully vaccinated against Covid-19?
Yes, I'm fully vaccinated
No, I'm not fully vaccinated
Date of second vaccination or booster
Please enter the date you received either your second Covid-19 dose or an additional Covid-19 booster.
Comments
Unfortunately, we are unable to continue with your application. In order to apply for a Volunteer role, you must be fully vaccinated against Covid-19. You can also call 0800 24 33 33 to speak to one of our helpful staff, who will be able to provide you with more information and assistance.
I understand
Your personal details
Title
Please select...
Mr
Mrs
Ms
Miss
Dr
Prof
Rev
Dame
Sir
Lady
Father
Sister
Brother
Lord
Master
Pastor
The Hon
The Right Hon
First Name
Middle Name
Last Name
Known as
Date of Birth
Your contact details
What is your call preference?
Please select...
Home Phone (Landline)
Mobile Phone
Work Phone
Home Phone (Landline)
Mobile Phone
Work Phone
Email
Your current residential address
Street Address
Suburb
City
Post Code
Region
Please select...
Auckland
Bay of Plenty
Canterbury
Gisborne
Hawke's Bay
Manawatu-Wanganui
Marlborough
Nelson
Northland
Otago
Southland
Taranaki
Tasman
Waikato
Wellington
West Coast
Next of Kin
Please give full details of your next of kin in case of an emergency
First Name
Last Name
Relationship to you
Please select...
Caregiver
Child
Friend
Grandchild
Guardian
Neighbour
Parent
Partner
Relative
Sibling
Spouse
Support Worker
Other
Home Phone
Mobile Phone
Email
References
Please give details of two referees who can be contacted (who have preferably known you for more than one year and are not family members).
Reference One
First Name
Last Name
Phone
Email
Reference Two
First Name
Last Name
Phone
Email
Your Volunteering Preferences
Tell us about yourself and why you want to volunteer with Blind Low Vision NZ
Your skills/areas of interest
Which volunteering areas would you be capable of and/or interested in:
Advocacy/Awareness
Arts/Crafts
Books/Library
Customer Service/Telephone Skills
Driving (car or van)
Fundraising/Events
Group Support
Guide Dogs
Individual Client Support
IT/Technology
Office/Administration
Peer Mentoring
Recreation/Sports
Working with youth
First Aid Current
Do you have any other skills or areas of interest not listed above?
Your availability
How long do you envisage can you volunteer for?
Less than 6 months
More than 6 months
What are your preferred days to volunteer?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
As Required
Your transport
Where driving is involved as part of your volunteering, will you use your own vehicle?
Yes
No
Additional Information about you
Are you blind or have low vision?
Yes, I'm blind or have low vision
No, I'm not blind or have low vision
Do you have any mental or physical health issues that may be affected by volunteering, or affect your ability to complete volunteer tasks?
Yes
No
If yes, please describe
Have you ever had a criminal conviction?
Yes, I have, or have had a criminal conviction
No, I do not have, and have never had a criminal conviction
If you do have a criminal conviction please explain details?
Your communication preferences
What would you like to receive information about:
Volunteer Newsletter
Surveys & Research
Street Collections
Fundraising Events
Donations & Bequests
Before you submit
Your Rights & Privacy
Blind Low Vision NZ is governed by the Health and Disability Code of Rights. Click here to find out about your rights under the Code.
Blind Low Vision NZ is committed to protecting your privacy and works in accordance with the Privacy Act 2020. Click here to find out about the Privacy Act 2020.
Blind Low Vision NZ will keep your information confidential, as outlined in our privacy statement. Click here to open our privacy statement.
Declaration
I certify that all information that I have provided to Blind Low Vision NZ is true, accurate and complete. I authorise Blind Low Vision NZ to contact my named referees to seek information from them that may be relevant to my application for voluntary service.
Yes, I acknowledge
I understand that If my volunteer application is successful, Blind Low Vision NZ will have to carry out a mandatory Police Vetting check to further process my application. I will have to provide a filled in and signed copy of the
NZ Police Vetting form
at a local Blind Low Vision NZ office along with the required identification.
Yes, I acknowledge
I acknowledge that I read and understood Blind Low Vision NZ's
Volunteer Agreement and Code of Conduct
and will sign a copy of the document shall my application be successful.
Yes, I acknowledge
Prepopulated ContactID
Prepopulated RegistrationID
Contact Information
Privacy Statement