Challenge Bathurst Volunteers Application 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 Day12345678910111213141516171819202122232425262728293031 MonthJanFebMarAprMayJunJulAugSepOctNovDec Note: If you are under 18, please contact robertjstanley@hotmail.com to obtain a copy of the paper application form. Shirt Size -Select-SMXL2XL3XL4XL5XL 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 (Other than standard lunch pack) Vegetarian Gluten Free What Days Are You Available? 4 days - Thursday through Sunday 2 days - Thursday and Friday 2 days - Saturday and Sunday 1st Preference Role -Select-Accreditation 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 offCompetitor Liaison - 2 or 4 days. Shift: 6:00am-noonCompetitor Liaison - 2 or 4 days. Shift: noon-6:00pmCompetitor Check-in - Wednesday and Friday only 8:00am-6:00pm 2nd Preference Role -Select-Accreditation 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 offCompetitor Liaison - 2 or 4 days. Shift: 6:00am-noonCompetitor Liaison - 2 or 4 days. Shift: noon-6:00pmCompetitor Check-in - Wednesday and Friday only 8:00am-6:00pm 3rd Preference Role -Select-Accreditation 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 offCompetitor Liaison - 2 or 4 days. Shift: 6:00am-noonCompetitor Liaison - 2 or 4 days. Shift: noon-6:00pmCompetitor Check-in - Wednesday and Friday only 8:00am-6:00pm 4th Preference Role -Select-Accreditation 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 offCompetitor Liaison - 2 or 4 days. Shift: 6:00am-noonCompetitor Liaison - 2 or 4 days. Shift: noon-6:00pmCompetitor Check-in - Wednesday and Friday only 8:00am-6:00pm If you selected Accrediation Centre or Competitor Check-in above, can you work in the Accrediation Centre or Competitor Check-in on Wednesday? Yes No Medical Condition Yes No Do you have a medical condition you wish to make us aware of? If so, enter it below. 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? 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