THKNH
Volunteer Form
Events

THKNH
Volunteer Form
Events

Volunteer Form

Thye Hua Kwan Nursing Home @ Hougang

Personal Particulars

First Name *

Middle Name

Last Name *

Gender

Female Male

Birth Date

NRIC/FIN/Passport No (Last 4 characters) *

Nationality

Home Address

Postal Code

Marital Status

Religion

Occupation

Employed	Self-Employed	Student
Unempolyed	Retired	Others

Name Of Company

If Chosen “Student” in “Occupation” field, please fill up “Name Of school” / “Course” or both

Name Of School

If chosen “Others” in “Occupation” field, please specify below

Occupation – Specify

Spoken Language Proficiency

English	Mandarin	Malay	Tamil
Cantonese	Hokkien	Teochew	Others

Home No:

Enter your mobile phone number in this format: +65XXXXXXXX

Mobile No: *

Email *

Areas of Service Interest

(Please tick top 3 interests)

Areas Of Service Interest

Art & Craft	Administration	Assist with Feeding	Assist with Occupational & Physiotherapy Sessions
Befriending	Cooking	Exercise	Entertainment(E.g. Karaoke)

Areas Of Service Interest – More options

Fundraising Activities	Gardening	Haircut Service	Housekeeping
Outings	Sewing	Baking	Others

Availability to Volunteer

(please tick)

Day

Mon Tues Wed Thurs Fri Sat Sun

Time

Morning Afternoon Evening

Let Us Know You Better!

Q1. How did you hear about us?

Q2. Do you have any previous/current voluntary work experience?

Yes No

If chosen “Yes” above, Please specify (VWO name/task):

Please specify (VWO name/task):

Q3. What motivates you to volunteer with Thye Hua Kwan Nursing Home?

Q4. List some of your skills and expertise:

Q5. Are you suffering from any physical impairment or disease?

No Yes

If chosen “Yes” above, Please elaborate:

Impairment/disease – Please elaborate:

Q6. Have you been convicted of or pleaded guilty to any crime(s)?

No Yes

If chosen “Yes” above, Please elaborate:

Crime – Please elaborate:

Q7. Are you affiliated and/or have dealings/transactions with any vendor,
supplier or any other party who is providing or bidding to provide
service to Thye Hua Kwan Nursing Home?

No Yes

If chosen “Yes” above, Please elaborate:

Are you affiliated and/or have dealings/transactions with any vendor,
supplier or any other party who is providing or bidding to provide
service to Thye Hua Kwan Nursing Home? – Please elaborate:

Personal Data Protection Act (PDPA)

By submitting this volunteer application form, you agree that Thye Hua Kwan Nursing Home maycollect, use and disclose your personal data, as provided in this application form, or obtained by our organisation as a result of your consent. In relation to the PDPA, we would like to seek your consent for the following: (Please tick on the boxes to indicate your consent)

I hereby give my consent for mentions and publicity for events and activities, including photographs/videos and social media, by Thye Hua Kwan Nursing Home. *

Yes No

I would like to receive updates, news and other volunteer related matters from Thye Hua Kwan Nursing Home through: *

Mail

Email

Phone/Messages

Please enter today’s date.

Date Application Submitted *

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