Name:

Email:

Postal Address:

Phone:

Mobile:

Date of Birth:

Gender: Male Female

Emergency contacts:


Type of Volunteer work: Day volunteer Live-in volunteer

What is your motivation for volunteering at Chenrezig Institute?


What are you hoping to achieve through volunteering at Chenrezig Institute?


What skills and training can you bring to Chenrezig Institute?


Have you done any volunteer work before? Please give details.


Have you been involved in a spiritual community before? Please give details.


Please supply email or phone numbers of one personal and one professional reference:

Personal Reference:

Name:

Phone number:

Relationship to you:

Professional Reference:

Name:

Phone number:

Relationship to you:

When could you commence volunteering at Chenrezig Institute?


What would be your period of commitment?


How have you spent the last three years? (eg: studying, working, traveling etc)


If you are traveling from overseas, please give an overview of your travel plans in Australia.


Do you currently, or have you had, any major or chronic physical problems? (eg asthma, allergies, diabetes, epilepsy etc) yes/no If yes please give details: Yes No


Do you currently have, or have experienced, any mental illness (eg: depression, bi-polar etc) Yes No

Have you had issues with drug or alcohol addiction? Yes No

Have you completed a detox program? If yes, please give details. Yes No


Are you currently taking medication or have you recently ceased taking medication? Yes No

Do you currently have an ongoing income or access to money to support yourself during your stay with Chenrezig Institute? Yes No

Do you have alternative accommodation to Chenrezig Institute if you had to leave the community with short notice? Yes No

Do you have a criminal record? If yes, please give details: Yes No


Would you be willing to have a criminal history check completed? Yes No

Do you have any special dietary requirements? If yes please give details: