6% of survey complete.
Name as in NRIC/ Passport (Indicating surname in CAPS)

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* 1. Name as in NRIC/ Passport (Indicating surname in CAPS)

NRIC Number

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* 2. NRIC Number

Date of Birth

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* 3. Date of Birth

Date of Birth
Email Address

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* 4. Email Address

Contact Number

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* 5. Contact Number

Gender

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* 6. Gender

Race

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* 7. Race

Nationality

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* 8. Nationality

Address

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* 9. Address

Occupation

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* 10. Occupation

Marital Status

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* 11. Marital Status

Religion

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* 12. Religion

Skills/ Hobbies/ Interests (State proficiency & if willing to teach/coach)

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* 13. Skills/ Hobbies/ Interests (State proficiency & if willing to teach/coach)

Highest Qualification

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* 14. Highest Qualification

Language Ability

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* 15. Language Ability

  Spoken Written
English
Mandarin
Malay
Tamil
Hokkien
Teochew
Cantonese
How did you find out about us

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* 16. How did you find out about us

Have you volunteered before? If yes, please elaborate.

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* 17. Have you volunteered before? If yes, please elaborate.

What motivated you to volunteer with us?

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* 18. What motivated you to volunteer with us?

Declaration

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* 19. Declaration

  Yes No
1) Have you been convicted in a court of law in any country before?
2) Have you been medically diagnosed with any mental / physical condition(s) which could prevent you from competently and safely offering your services(s) as a volunteer?
3) Have you been addicted to the use of alcohol or to habitual use of narcotics / other habit forming drugs?
If you have answered "Yes" to any of the statements, please provide details

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* 20. If you have answered "Yes" to any of the statements, please provide details

Agreement

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* 21. Agreement

  Yes No
I agree to treat all personal information of clients as confidential (including all pictures and videos of clients or events etc.) and will not collect, use or disclose such information without the permission of BCCSC
I accept that participation in activities involves certain amount of risk. Whilst due care is taken by BCCSC to manage and minimise risk, I undertake to release and discharge BCCSC, its staff, volunteers, beneficiaries, partners or other servants or agents from all liabilities, claims and expenses, for any accident, injury, loss or damage, whether directly or indirectly by and/or to myself/ other person(s)/ other organisation(s) that may occur in the course of, or as a result of participating in such activities.
In the event of any risk incidents, I agree to inform BCCSC and the organisers immediately and assist with any incident inquiry.
I understand and agree that the personal information which I have provided may be used for purposes related to volunteering at BCCSC. Personal information given will only be used to maintain or enhance relationship with BCCSC.
I declare that all information given is accurate at the time of completion and understand that the approval of my application is subjected to the consideration of BCCSC.
Volunteer Role

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* 22. Volunteer Role

T