Volunteer Application Form 12112010

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VOLUNTEER APPLICATION FORM

Youth Guidance Centre @
Eunos
FOR OFFICIAL USE ONLY

Received:
Vol No: Screening Result & Date: S/NS
Screening Sent: dated
Photograph
Assignment: Mentor / Support Volunteer / Trainer
(Kindly indicate
Mentee: your name on
Mentoring Org: the reverse side)
Thank you for taking interest to invest into another’s life through
mentoring. Kindly complete this application form legibly to allow us to
process your application and also to get to know you better. Please
allow approximately 2 weeks for processing of your application.
SECTION A: PERSONAL PARTICULARS

Dr / Mr / Mrs / Miss / Mdm * NRIC / FIN No *^:
Full Name (as in NRIC, indicating surname in
CAPS):

Date of Birth Gender*: Citizenship*:
(dd/mm/yy): Male / Female Singaporean / PR / Others (Please Specify):

Race: Religion: Marital Status*:
Single / Married / Separated / Divorced / Widowed
Address: Email:

Contact No (HP): Contact No (Tel): Contact No. (Off): Contact No.
(Others):

SECTION B: EMPLOYMENT, EDUCATION & SKILLS
* Please delete as appropriate | #

Required Information | ^ Kindly include documentation where Page 1 of 6
applicable
Version: 12 Nov 2010
Blk 609, Bedok Reservoir Road, #01-690 S470609 | Tel: 6242-6306 | Fax: 6242-8065 | www.studentadvisory.org.sg |
ygc@studentadvisory.org.sg |
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Occupation: Employer / School (applicable to

students):

Highest Educational Qualification*: Course of Study: Accreditation (if
Higher Degree/ Degree/ Diploma/ “A” any) ^:
Levels/ “O” Levels/ PSLE/ No Formal
Education | (Kindly Specify)
Language(s) Spoken (including Language(s) Written:
dialects):

Please share with us your skills, hobbies and interests [kindly indicate your
level of proficiency (e.g. beginner, intermediate, advanced, able to train, certified)
beside each skill] ^:

SECTION C: VOLUNTEERISM INFORMATION

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How did you come to know of this Are you applying to be a volunteer for
volunteer opportunity/assignment? the fulfillment of requirements for Yes / No
(Please tick all that is applicable): community involvement e.g. awards *
Friends / Relatives / Teachers / and/or course requirement(s)?
Colleagues Do you require certification of your Yes / No
Volunteer Matching Services voluntary involvement? *
Media / Internet / Newspapers
Other Non-Profit Organizations Have you previously contacted us Yes / No
Experience
Youth Guidance Centre Volunteers about volunteering? *

Youth Guidance Centre Staff Have you ever served as a volunteer
first)
Youth Guidance Centre website mentor before? (Please provide details Yes / No
Others (Please specify): in the “Past Voluntary Experience” *
experience
segment below)
Voluntary
Period of
Organization Description of Responsibilities Involvement (e.g
mm/yy – mm/yy)

(Latest
Past

I am interested to join Youth Guidance Centre as a… (Please tick all that is

applicable)
Volunteer
Mentor What are some activities you can engage with your mentee?
(See pg 4 for role
description)
Which area would you like to provide support in (e.g.
Support
Photographer, Graphics Designer, Web Designer etc)?
Volunteer

Volunteer Which area would you like to provide training in?
Trainer
Any other relevant/useful information we should know to help us match you with your
mentee/perform your assignment effectively?
Mon Tue Wed Thu Fri Sat Sun

Availability
Morning
Afterno
on
Evening

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SECTION D: NEXT-OF-KIN & REFERENCES (Kind provide references other

than your family members)
Next-of-Kin (In case of emergency, please contact…)
Name: Relationship: Contact No:
References (Please provide 2 references)
Reference’s Name Relationship Years Contact No.
Known

SECTION E: DECLARATION & AGREEMENT

1. Have you been medically diagnosed with any mental / physical condition(s) Yes / No
which could prevent you from competently and safely offering your service(s) *
as a volunteer?
2. Have you been addicted to the use of alcohol or to habitual use of narcotics /
Yes / No
other habit forming drugs? *
3. Do you have a criminal record in Singapore? Yes / No
*
4. Have you been charged with any offence in a court of law in any country for Yes / No
which the outcome is not yet known (excluding parking offences)? *
5. Remarks (Kindly indicate any remarks you may have e.g. remarks for any of the above
statements which you may have responded “yes”):

By submitting this application and by participating as a volunteer, I, the undersigned, affirms
that I have read, understands and agrees with the following:
(a) I hereby accept full responsibility for the accuracy and completeness of the information and
accompanying documents contained herein and understand that any false or misleading
information in, or in connection with my application, may be cause for rejection / conclusion of
voluntary service. As such, I also authorise Youth Guidance Centre (YGC) to verify any and all
information contained herein, to confirm the accuracy and completeness of the information.
(b) My involvement in YGC is solely on voluntary basis and shall not involve any form of remunerations,
both in monetary terms (e.g. allowance and reimbursement of expenses) as well as in kind (e.g.
accommodations and loan of organizational assets), in return for service(s) rendered, unless
otherwise stated;
(c) I may be required to undergo “security screening”, prior to the confirmation and commencement of
my placement and also periodically during my assignment, as to be advised by YGC;
(d) YGC will not be liable for any injuries or loss of properties incurred as a result of participating in
such activities;
(e) I may be required to undergo a period of probation to ensure that there is a match between me and
the assignment within which I am rendering my services;
(f) YGC reserves the right to reject an application / change the placement of a volunteer (in
consultation with the volunteer), should it deem that there is no fit or if YGC evaluates that he/she
might be better able to contribute to the care of beneficiaries via other means. Failing which, the
services may be concluded;
(g) I will abide by the policies and procedures set forth by YGC, which guides the work of the staff and
volunteers in their work with the beneficiaries. When in doubt, I will refer to the Volunteer
Coordinator or respective staff for clarifications, and
(h) I agree that I will respect the various guiding principles, values and standards of this organisation.
(i) I agree to the commitment and to participate to the best of my ability.
(j) I will honour confidential information regarding my mentee, except in cases of abuse or neglect, or
when it appears that the mentee is of danger to him/herself and/or others. In such cases, I agree to

applicable
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inform YGC immediately.

(k) I agree to provide regular reports and relevant inputs on the progress of the mentoring relationship
to YGC, as to be determined by YGC.
(l) I agree to attend case meetings and training sessions.
(m) I will inform YGC of any change in address or contact information.

Date Signature of Applicant

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Volunteer Mentor Role Description
Want to invest in the lives of at-risk youths and see them grow to be a person
who can achieve his/her potential; one who would be a future contributor to
society and a blessing to others? Then, come alongside and join us as a youth
mentor. Your involvement goes a long way in paving the future of the youths in
our community…
Requirements
At least 18 years old
Able to attend mentorship training (Estimated 3 days training over a
span of time)
Has passion in working with at-risk youths
Cleared security screening
Able to provide required periodic updates on the progress of the mentees
Relevant experience with working with youth-at-risk or youth offenders
an advantage
Has relevant interest(s) e.g. sports, music etc which can be used to
engage mentees
Role
Establishes rapport and trust with the youth
Shares and provides guidance and support, constructively challenges
and advices to encourage meaningful development a youth's character,
capacities, ability to contribute and communication skills.
Provides regular progress updates on the mentee
Commitment Period
Minimum of 1 year from completion of training & matching to mentee
Minimum of 2 face-to-face interaction (4 hours) per month
1-to-1 mentoring
Location:
Mentors will be mentoring youths staying in the Aljunied GRC region
(Note: Mentors do not have to be staying in the Aljunied GRC)

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Volunteer Application Form 12112010

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CONFIDEN

VOLUNTEER APPLICATION FORM

FOR OFFICIAL USE ONLY

SECTION A: PERSONAL PARTICULARS

SECTION B: EMPLOYMENT, EDUCATION & SKILLS

* Please delete as appropriate | #

VOLUNTEER APPLICATION FORM

Occupation: Employer / School (applicable to

SECTION C: VOLUNTEERISM INFORMATION

* Please delete as appropriate | #

VOLUNTEER APPLICATION FORM

Youth Guidance Centre Volunteers about volunteering? *

I am interested to join Youth Guidance Centre as a… (Please tick all that is

Mon Tue Wed Thu Fri Sat Sun

* Please delete as appropriate | #

VOLUNTEER APPLICATION FORM

SECTION D: NEXT-OF-KIN & REFERENCES (Kind provide references other

SECTION E: DECLARATION & AGREEMENT

* Please delete as appropriate | #

VOLUNTEER APPLICATION FORM

inform YGC immediately.

* Please delete as appropriate | #

VOLUNTEER APPLICATION FORM

Volunteer Mentor Role Description

* Please delete as appropriate | #

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