ROTARY AUSTRALIA
WORLD COMMUNITY SERVICE Ltd.
ACN 003 444 264 ABN 37 739 341 003
VOLUNTEER APPLICATION FORM
SURNAME________________________ GIVEN NAMES____________________________
MALE / FEMALE MARRIED / SINGLE
AGE___________ NAME for BADGE__________________________
ADDRESS______________________________________________
TOWN or CITY__________________________________________POST CODE_________
CONTACT Nos. Home( )_______________________Work( )_______________________
Fax ( )___________________ Mob. ( ) ________________ E-Mail___________________
Rotarian _______ Non Rotarian______ Member of the Rotary Club of_____________________
District _______________
Preferred Dates of Volunteer Service_________________________________________
Period you wish to render voluntary service.____________________________________
Period you wish to engage in other activities (e.g. Cultural
Exchange)__________________
OCCUPATION ________________________________________________________
TRADE, PROFESSIONAL or HANDYMAN SKILLS and EXPERIENCE_________________
____________________________________________________________________________
LIST PARTICIPATION IN ANY PREVIOUS WORLD COMMUNITY SERVICE PROJECTS___________________________________________________________________
____________________________________________________________________________
LIST IN ORDER THE PROJECTS IN WHICH YOU WOULD LIKE TO PARTICIPATE________________________________________________________________
____________________________________________________________________________
CONTACT WHILE VOLUNTEER IS AWAY ON PROJECT
NAME _______________________________ ADDRESS _________________________
(PARTNER or GUARDIAN) TOWN or CITY ______________________
PHONE No.s Home( ) ___________________ Bus( ) ___________________________
Fax.( ) _________________Mob ( ) _____________E-Mail ______________________
NATIONALITY of VOLUNTEER____________________ PASSPORT NO._______________
EXP. DATE SHOWN IN PASSPORT______________________________
PLEASE INDICATE WHO IS MAKING DONATION
1. Volunteer (or) $_________ 2. Rotary Club (or) $_____________
3. Others $_________
VOLUNTEER HEALTH STATEMENT Please complete the attached medical statement
Any further comments. _____________________________________________
Do you require a BADGE (YES) (NO) TEE SHIRT (YES) (NO) SIZE
Frequent flyer Number.__________________________________________________
A statement from your doctor on the RAWCS Ltd. form will be required if your application is accepted and you are allocated to a project.
VOLUNTEERS SIGNATURE _____________________________ DATE. _____/_____/___
PRESIDENT OF THE ROTARY CLUB OF___________________________________
SIGNATURE ___________________________________________ DATE.
_____/_____/___
Please answer all questions and complete and sign the agreement on the reverse side.
VOLUNTEER AGREEMENT
THIS AGREEMENT made this (day) of (month) (year) between
ROTARY AUSTRALIA WORLD COMMUNITY SERVICE Ltd ACN 003 444 264 (herein after called "RAWCS" ) with its principal office at______________________________Project Co-Ordinator_________________________
AND (Full name of volunteer)____________________________________________________
of____________________________________________________________(herein after called "the volunteer")
WHEREAS THE OBJECTIVES of RAWCS programmes are designed to encourage the advancement of International Understanding, Goodwill and Peace in developing countries.
AND WHEREAS RAWCS desires to encourage and organise Volunteer training teams to assist with developmental projects to meet these objectives
AND WHEREAS the Volunteer desires to be involved in the project at ____________________________
NOW IN consideration of the premises, the promises and the mutual benefits to be gained by the performance thereof, the parties hereto agree as follows:-
1. TERM- The term of the Volunteer Agreement shall be for approximately 2 weeks and the Volunteer’s responsibility shall commence on the day of departure from Australia and continue until arrival back in Australia provided, of course, at all times that should the Volunteer break the trip to or from for personal or private reasons, then this Agreement shall only commence at the time when the volunteer leaves to take up the appointment in respect of the project, the subject of this agreement and will only continue until the volunteer leaves the project unless returning directly to Australia, when the Agreement shall continue until arrival in Australia.
2. DUTIES- The Volunteer’s duties under this Volunteer Agreement include:-
2.1. Travel to and from a destination in such transport as shall be arranged by RAWCS or otherwise.
2.2 Carry out volunteer activities under the direction of the Project Co-ordinator or a competent person appointed by him /her and / or any health or welfare activities designed by the Project C-ordinator or his/her nominee.
3. COMPENSATION- RAWCS shall compensate the Volunteer as follows:-
3.1 RAWCS shall pay or arrange for the Volunteer’s return air fares and any other costs for transportation overseas to and from the project site.
3.2 RAWCS will provide the Volunteer with food and accommodation and where this is not possible RAWCS will make other arrangements and inform the Volunteer of them prior to departure.
4. INSURANCE. The Volunteer acknowledges that he or she has read the terms and conditions of the Insurance Cover provided under the respective Rotary Districts in Australia including the Cigna rescue procedure. The Volunteer acknowledges the insurance cover shall indemnify and save harmless RAWCS in respect of any claim arising by the Volunteer under such insurance. The Volunteer acknowledges that RAWCS shall have no responsibilities to provide insurance cover of any other kind for the Volunteer and the Volunteer undertakes to indemnify RAWCS in respect of any such claim made by the Volunteer as a result of being involved in the project. The Volunteer further acknowledges that where the Volunteer considers it necessary, prior to departure from Australia, to arrange any other such insurance cover as the Volunteer sees fit, then he or she shall not rely on RAWCS in any way to provide or arrange such cover
5. ILLNESS. The Volunteer acknowledges that the nature of the project may have special requirements in relation to health and or fitness of the Volunteer. The Volunteer shall seek his/her own medical advice as to appropriate steps and measures that should be taken by the Volunteer as to such medical conditions, immunisations, inoculations or otherwise having regard to the country in which the Volunteer will be attending the project. The Volunteer acknowledges that whilst the RAWCS Project Co-ordinator or nominee will take whatever action he or she is able to assist any team member who falls sick or sustains an accident the Volunteer acknowledges that as the projects may be in remote areas where normal and adequate medical assistance may not be available, then, the Volunteer acknowledges that he / she must produce to the Project Co-ordinator or the representative of RAWCS a certificate as to fitness executed by his or her medical advisor.
6. TERMINATION BY VOLUNTEER. Notwithstanding any provision in this agreement to the contrary, in the event the Volunteer terminates his / her service with RAWCS before the end of the term of this agreement for any reason not necessitated by concern for the health of the Volunteer, compensation as provided in para. 3 hereof shall cease upon the termination of service.
7. TERMINATION BY RAWCS- The team leader reserves the right to instruct the Volunteer to return to Australia and / or leave the project where in his / her opinion the Volunteer is not performing in a proper manner and the Volunteers presence is disruptive and contrary to what is expected of a Volunteer on a Rotary project.
8. RELATIONSHIP CREATED- The Volunteer acknowledges that the relationship of employer and employee shall not arise in respect of RAWCS and is expressly understood at all times that the Volunteer is an independent contractor and not otherwise. The Volunteer agrees to indemnify RAWCS in respect of any claim arising as a result of the relationship.
IN WITNESS WHEREOF
SIGNED________________________ (VOLUNTEER) WITNESS ______________________________
SIGNED ________________________(PROJECT CO-ORDINATOR) WITNESS ______________________________
ROTARY AUSTRALIA
WORLD COMMUNITY SERVICE Ltd.