Get involved Volunteering Current: Become a volunteer Become a volunteer We value our volunteers! We have some new and exciting roles coming up over the next few months. Please fill out this expression of interest form below. Please note you must be 18 years or older to be a volunteer. Personal details: Legal full name: Preferred name: Email address: Phone number: Date of birth: Home address: Do you have the right to work in Australia? Merri Health is dedicated to ensure inclusive practices are embedded in the heart of what we do. This includes but is not limited to creating a safe culture for Aboriginal and Torres Strait Islander peoples, those from the LGBTIQA+ community, and those who identify as gender diverse. Merri has several policies and procedures in place to support diversity and inclusion internally and within our services. Diversity data is collected to ensure Merri meets our requirements and expectations in these areas and to assist in the ongoing accreditation process such as a Rainbow Tick organisation. Additionally, it allows Merri to continue to apply ongoing assistance programs and grants in these areas for our employees, volunteers, students, and clients. 1. What is your gender identity? Woman Man Non-binary Agender Transgender Gender diverse Sistergirl Brotherboy Prefer not to say 2. Do you identify as being a member of one or more of the LGBTIQA+ communities? Yes No Prefer not to say 2.a. Where answer to (2) is Yes: Which one or more do you identify with: Lesbian Gay Bisexual Trans Intersex Queer Questioning Asexual Plus Prefer not to say 3. What are your preferred pronouns? Sher/her She/they He/his He/they They/them Name/Name Prefer not to say 4. Do you identify as being of Aboriginal and/or Torres Strait Islander decent? Aboriginal Torres Strait Islander Aboriginal and Torres Strait Islander No/neither Prefer not to say Merri Health has a Reconciliation Action Plan (RAP) Committee which focuses on the strategic implementation of Merri’s RAP. Would you like a member of the RAP Committee to contact you and discuss if you wish to join the committee? Yes No (if at any stage you change your mind, please let your manager know and they can connect you with a member of the Committee) 5. What is your Country of Birth? 6. What language(s) do you speak? Availability and interest: 1. Preferred number of hours per week? (Please note this can not be more than 16 hours per week): 2. Merri has a mixture of ongoing assignments vs short term projects, do you have a preference and if so, which one Ongoing Short term Both 3. Please describe your preferred area(s) to which you would like to volunteer in Please indicate your availability (Monday - Sunday) Why volunteer? 1. How did you find out about Merri and what is your understanding of what Merri does? 2. What is motivating you to apply to be a volunteer for Merri? 3. What skills, experience and personal attributes can you bring to Merri Health? 4. Is there anything else you would like to tell us? Conflict of interest: Conflict of interest exists where a personal interest, aim, goal, personal business interest or desired outcome influences or could be perceived to influence the way you carry out your duties as a Merri Health (Merri) employee or volunteer. Please refer to the Code of Conduct for further detailed information. As required, I have outlined other employment undertaken outside my work with Merri: I am involved in the following activities which could pose a conflict of interest Pre-existing conditions closure: Merri is committed to provide a safe work environment for all volunteers. It’s our aim to ensure volunteers are not engaged to undertake duties they are not able to perform safely. You will be provided with a Job Description with placement requirements. It is our aim to ensure volunteers are not engaged to undertake duties they are not able to perform safely. With that in mind, you will be provided with a Job Description describing the inherent requirements of the placement. You are required to disclose to Merri any pre-existing condition(s) that you have suffered of which you are aware and could reasonably be expected to foresee could be affected by the nature of the proposed position referred to above. A health condition that may require Merri to provide me services, aids or adjustments so that I can adequately perform the inherent requirements of this position as set out in the Position Description. Any adjustments I may need have been disclosed below. I have I do not have Declaration: I agree to provide a current National Police Records Check, through Merri’s provider prior to commencing my volunteer role with Merri. I understand that I am also required to renew my National Police Records Check every 3 years while engaged by Merri. Ple I have read through the Immunisation Policy and understand what vaccines are required or have been recommended for my position category at Merri, specifically I acknowledge I can not volunteer with Merri unless I have had three COVID-19 vaccines or a medi I declare that the information I have provided on this form is true and correct and I have provided full disclosure of all information required by Merri, I understand that if it found that I have knowingly provided false information my volunteer engagemen