Application form

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Bait station clearing and filling – Waipapa and Pikiariki in Pureora Forest application form

Volunteer activity

During what month(s) would you prefer to volunteer?

Contact details

Name as on passport

Preferred to be called

Address box

Phone

Mobile

Personal details

Date of birth

Country of residence

Emergency contact

Contact name

Contact phone number

Relationship to me

For international volunteers, add a New Zealand contact if available:

Contact name

Contact number

Relationship to me

Medical conditions

For my own health and safety, the following pre-existing medical conditions, allergies or past injuries and special dietary needs are for DOC to note.

Enter none if this is the case

Fitness

Volunteer activities span a range of fitness levels. Some activities may be specific in their requirements (as outlined in the volunteer role description). Tick the box that most accurately reflects your current level of fitness.

What is your fitness level? Low - you can easily walk up to 2 hours over flat ground Medium - you can comfortably walk with 5 kg pack up to 4 hours over uneven ground High - you are capable of walking with 10 kg pack up to 6 hours over uneven ground Very high - you are experienced at walking consecutive days with 10+ kg pack over steep, rough terrain

Licences/certificates

Do you have any relevant licences or certificates?

Drivers licence

First aid

Others

Relevant skills and experience

If selected other state your relevant skills and experience

Have you had previous conservation volunteering experience? With Department of Conservation (list previous dates and place below) With other conservation or environmental organisations At other organised events Limited, but keen to participate

Previous date and place volunteering for DOC (maximum three)

Do you give consent to have your details shared with other conservation groups if they need volunteers? Yes No

Additional comments relevant to my application