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South West Compassionate Communities Network
Caring, dying and grieving is everyone's business
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Expression of Interest Form – Compassionate Community Connector
Expression of Interest Form – Compassionate Community Connector
Please complete form below to submit your Expression of Interest.
First Name
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Last Name
*
Email
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What town or suburb do you live in?
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PhoneNumber
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Please enter your best contact phone number
PostCode
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1. Have you ever done volunteer work before?
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Yes
No
1. If yes, please outline previous volunteer work
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2. Why would you like to volunteer as a Compassionate Community Connector?
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3. What do you hope to gain from volunteering as a Compassionate Communities connector?
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4. What attributes/qualities do you feel you will bring to the role of Compassionate Communities Connector?
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5. What experience (if any) do you have of supporting people living with advanced life limiting illness?
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6. Have you experienced a significant loss in the last two years?
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Yes
No
6. Please give details (of significant loss)
7. Is there anything that might affect your participation as a Compassionate Communities Connector?
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Yes
No
7. Please give details (of anything that might affect your participation)
8. Do you have any medical conditions/illness that might affect your work as a Compassionate Communities Connector?
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Yes
No
8. Please give details (of medical conditions/illnesses that might affect your work as a Connector)
9. A Compassionate Communities Volunteer needs to be flexible and available. Please outline your flexibility and availability here
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10. Are you currently involved/associated with any other community-based organisations?
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Yes
No
10. Please provide details of current involvements/associations
Do you have any dietary requirements for the training day?
Email
Submit
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