To apply to become a volunteer at Challenge Bathurst, please fill out the form below. Title * - Select -MrMrsMissMs First Name * Middle Initial Last Name * Date of Birth * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Note: If you are under 18, please contact robertjstanley@hotmail.com to obtain a copy of the paper application form. Shirt Size * - Select -SMLXL2XL3XL4XL5XL Address 1 * Address 2 Suburb * State * - Select -NSWVICQLDSAWATASACTNTOVS Postcode Phone (Work) Phone (Home) Phone (Mobile) Occupation Email Address * Next of Kin Name * Next of Kin Relationship * Next of Kin Address * Next of Kin Phone * Dietary Requirements Vegetarian Gluten Free Diabetic What Days Are You Available? * 4 days - Thursday 16 November 2017 through Sunday 19 November 2017 2 days - Thursday 16 November 2017 and Friday 17 November 2017 2 days - Saturday 18 November 2017 and Sunday 19 November 2017 1st Preference Role * - Select -Media Centre - 2 or 4 days. Shift: 8:00am-5:30pmAccreditation Centre - 2 or 4 days. Shift: 6:00am-noonAccreditation Centre - 2 or 4 days. Shift: noon-6:00pmVolunteer Checkin - 2 or 4 days. Shift: 5.30am – 7.30pm with regular time off 2nd Preference Role * - Select -Media Centre - 2 or 4 days. Shift: 8:00am-5:30pmAccreditation Centre - 2 or 4 days. Shift: 6:00am-noonAccreditation Centre - 2 or 4 days. Shift: noon-6:00pmVolunteer Checkin - 2 or 4 days. Shift: 5.30am – 7.30pm with regular time off 3rd Preference Role * - Select -Media Centre - 2 or 4 days. Shift: 8:00am-5:30pmAccreditation Centre - 2 or 4 days. Shift: 6:00am-noonAccreditation Centre - 2 or 4 days. Shift: noon-6:00pmVolunteer Checkin - 2 or 4 days. Shift: 5.30am – 7.30pm with regular time off 4th Preference Role * - Select -Media Centre - 2 or 4 days. Shift: 8:00am-5:30pmAccreditation Centre - 2 or 4 days. Shift: 6:00am-noonAccreditation Centre - 2 or 4 days. Shift: noon-6:00pmVolunteer Checkin - 2 or 4 days. Shift: 5.30am – 7.30pm with regular time off If you selected Accrediation Centre above, can you work in the Accrediation Centre on Wednesday 15 November? Yes No Medical Condition * Yes No Do you have a medical condition you wish to make us aware of? If so, enter it below. Medical Condition Name Do you require a camp site? * Yes No If you answered Yes to this question, continue answering the questions. If you answered No, submit the form below. Campsite: How many people will be on the campsite? Campsite: Names of people on campsite Enter the names of the people on your campsite other than you, separate multiple entries with commas (e.g. John Smith, Mary Smith) Campsite: Are you willing to share a campsite? Yes No Campsite: Preferred Campsite Location See the campsite map for more information. Campsite: Vehicle Registration Plate Number (if known) Campsite: Type of Camping - None -CaravanTent
