PRIVATE AND CONFIDENTIAL

Counterpart is committed to protecting your privacy and the confidentiality and security of personal information provided by you to us. Consistent with the relevant privacy legislation, we ensure that your personal information will not be disclosed to others, except if required by law or other regulation.

Thank you for your interest in Counterpart and your willingness to apply to be part of our volunteer program. Please complete the following information to help us gain a better understanding of you and your cancer experience.

Applications close on 2 February 2024.

To save your progress to continue later, please click on 'Save and Continue Later', located at the bottom of the page.

We strongly recommend that you read the Peer Support Volunteer Position Description before completing this form.

Questions with an asterisk (*) are compulsory.

22. On the successful completion of the training, which days will you be available to volunteer?

35. Please provide the name, address and telephone number of a referee whom we can contact. This can be a relative, friend, work colleague or anyone else that you would be happy for us to speak to. Please explain their relationship to you.