St Luke's ElderCare

Individual Volunteer Registration Form

*For Group Volunteering opportunities, please email to volunteer@slec.org.sg

Contact Details Applicant Details Volunteer History Emergency Contact

Contact Details

Salutation

Given Name

Surname

Last 4 Characters of NRIC/FIN (E.g. 123A)

Date Of Birth

Mobile Number

Email Address

Address (Blk Number, Street Name)

Unit No

Postal Code

Applicant Details

Nationality

Please Specify Nationality

Race

Please Specify Race

Religion

Please Specify Religion

Please Specify Denomination

Church Attending

Language

Please Specify Languages

Dialects Spoken

Please Specify Dialects

Occupation Status

Occupation

Preferred Centre

Availability

Preferred Timeslot

Frequency

What volunteer roles are you interested in?

Volunteer Roles (Others)

What activities will you like to conduct?

Please Specify Preferred Activity

Preferred Start Date

Are you currently undergoing any treatment, taking any medication, or have any pre-existing / existing medical conditions?

If yes, kindly elaborate

Do you have any prior criminal convictions?

If yes, kindly elaborate

How did you get to know about St Luke's ElderCare?

Please Specify

Volunteer History

What motivates you to volunteer at SLEC?

Please Specify

Name of Group

Name of Church

Name of Corporate

Name of School

Do you have any prior experience volunteering with the elderly?

Kindly share your experiences.

Emergency Contact

Given Name

Surname

Email address

Relationship of Emergency Contact

Please Specify Relationship

Mobile Number

Home Tel

Address (Blk Number, Street Name)

Unit Number

Postal Code

I agree to the terms and conditions of the Letter of Undertaking.

I agree to the terms and conditions of the Letter of St Luke’s ElderCare’s privacy policy.