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Register a Volunteer
First Name
Last Name
Gender
Male
Female
Date of Birth
Email
Password (Min. 6 characters)
Confirm Password
Home Phone
Work Phone
Mobile Phone
Address Finder
Please indicate the services you could help with.
Dr. General Surgeon
Please enter professional registration number:
aa Care of children
:
aa Deliver medicine, food or supplies
:
aa Preparation of meals
:
aa Transport person
:
Ambulance, Advanced Paramedic
:
Ambulance, Ambulance Officer
:
Ambulance, Paramedic
:
Ambulance, Upskilled paramedic
:
Anaesthetic technician
Please enter professional registration number:
Designated Medical Examiner
Please enter professional registration number :
Dr. Anaesthetist
Please enter professional registration number:
Dr. Emergency Physician
Please enter professional registration number:
Dr. General Medical
Please enter professional registration number:
Dr. General Practicioner
Please enter professional registration number:
Dr. Infectious Disease
:
Dr. Intensivist
Please enter professional registration number:
Dr. Orthopaedic Surgeon
Please enter professional registration number:
Dr. Paediatrician
Please enter professional registration number:
Dr. Plastic Surgeon
Please enter professional registration number:
Dr. Public health
Please enter professional registration number:
Midwife
:
Occupational Therapist
:
Pharmacist
:
Physiotherapist
:
Psychotherapist
:
RN
:
RN Emergency Dept
:
RN emergency dept
:
RN Infectious Disease
:
RN Intensive Care
:
RN Neuro
:
RN Ortho
:
RN Paed. intensive care
:
RN Palliative care
:
RN Practice Nurse
:
RN Public Health
Please enter professional registration number:
RN Respiratory
:
RN Theatre
Please enter professional registration number:
RN Vascular
:
xx Other Please state
:
Referee:
We may need to confirm your suitability for certain tasks by speaking to a referee. Suitable referees may be organisers of local community groups or service clubs, churches, or JPs.
If you are able to provide a referee, please enter their details here.
Organisation:
Name:
Phone:
I speak this language(s)
English
Samoan
Tongan
I am of this ethnicity
Cook Island
Fijian
New Zealander
Niuean
Samoan
Tokeluan
Tongan
I am generally available
Any time
Weekdays - any time
Weekends - any time
Weekday mornings
Weekday afternoons
Weekday evenings
Weekend mornings
Weekend afternoons
Weekend evenings
with these limitations
I have my own transport
I consent to a Police Check