PANDA Volunteer Application Form

Thank you for your interest in becoming a PANDA volunteer. PANDA is a mutual support self help organization and as such recruits volunteers who have either directly or indirectly experienced post and antenatal depression.

Please fill in and submit this form  or  print, complete and mail, fax or e-mail this printable form to PANDA at the address below:

810 Nicholson St.
North Fitzroy VIC 3068
AUSTRALIA
Support: 1300 726 306

Admin:   (03) 9481 3377   Fax:   (03) 9482 6210
E-mail: info@panda.org.au

A0007201S   ABN 64 063 647 374

Date of Application:   

Contact Details:

All the fields marked with * are mandatory

Title*: 

First Name:* 
Surname:* 
D.O.B.* (dd/mm/yy)
Address:*
Suburb:*
State:*
Postcode:* 
Telephone: (home)*    (work)* 
Mobile: 
Email:

Emergency Contacts (please provide two contacts)


1st Emergency Contact

Title*:
First Name:* 
Surname:* 
Relationship to you*: 
Telephone: (home)*    (work)* 
Mobile: 
Email:

2nd Emergency Contact

Title*:
First Name:* 
Surname:* 
Relationship to you*: 
Telephone: (home)*    (work)* 
Mobile: 
Email:

Please tell us about yourself:

Where did you hear about PANDA?

What is your reason for wanting to become a PANDA Volunteer?

Do you have any special skills or qualifications? (Please list)

Do you speak any languages other than English?

Do you have any children? If yes, what age are they?

Have your, or are you currently suffering from post and antenatal depression?
 Currently    Previously    No

Have you had any other experience with post and antenatal depression?

Have you previously, or are you currently, suffering from depression? If so, please state which.

For those who have experienced post or antenatal depression, or who have supported someone experiencing post or antenatal depression please briefly describe your experience.

Do you have any illnesses, personal circumstances or problems that may affect your ability to perform as a volunteer?

Opportunities for Volunteer work with PANDA

Please indicate which areas of Volunteer work you would like to be involved in.

 Telephone Support

This requires you to attend the PANDA office to provide telephone support/information to women, families and workers who ring in relation to post and antnatal depression.  PANDA requires 1 x 3 ½ hour shift per week. PANDA provides training at no cost to the volunteer.  Pre-requisite - a high level of communication & interpersonal skills or counseling skills.


Health Promotion Programs


 First time parent's group workshops
"Transition to motherhood" workshops for parent groups and ante natal groups, aiming at prevention of post and antenatal depression.  (Pre-requisite - group facilitation experience).

 Partner Sessions
Men who have experience of supporting someone with post and antenatal depression, share their experience.

 Public Speaking


PANDA receives requests to provide guest speakers at agencies, community groups etc.

 Fund Raising


PANDA receives core funding from the Department of Human Services.  This funding only covers salaries and PANDA is keen to raise money to fund the many projects we have planned to support women and their families and raise community awareness of post and antenatal depression

 Committee of Management


PANDA is managed by a volunteer committee of management.  This is a demanding but rewarding role.  We are particularly looking for volunteers with experience in a variety of areas i.e. accounting, fund raising and management, community development and health promotion.  We also need volunteers on the committee with personal experiences of antenatal or postnatal depression.

Privacy Statement


PANDA needs to collect personal information about volunteers.  PANDA uses this personal information in the training, placement and supervision of volunteers.  Personal information is also collected to satisfy occupational health and safety obligations and insurance requirements.

Personal information is collected to assist PANDA in advising volunteers of PANDA's activities or activities that PANDA has access to.  Personal information relating to volunteers will be collected on the prescribed form.  PANDA will ensure that personal information collected will be protected from misuse or unauthorized access.  Volunteers representing PANDA at external functions and agencies may have personal information relevant to the performance of their volunteer duties released by PANDA to the external agency.  This will be conducted with the consent of each volunteer involved.

   
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