Volunteer With Us | Haven Hub Limerick

Name *

First

Last

Which Haven Hub Branch do you wish to support? *

Address *

Phone Number *

Email *

Are you over 23 ? *

Yes
No

If no, are you studying Psychology/Psychotherapy with college supervision? *

Yes
No

What are your reasons for wanting to become a volunteer with the Haven Hub?

Briefly outline any hobbies, interests or qualifications you have that you feel may be relevant to your application: *

Have you lost a loved one through suicide or felt suicidal in the past 2 years *

Yes
No

Do you have any special support needs we should be aware of? *

Yes
No

If yes please expand

Please indicate the area you would be interested in volunteering in: *

Have you ASSIST or any Suicide Prevention Training done? (If not we will provide training)

Yes
No
Require refresher

The Haven Hub is open from 8pm-3.30am Fri and Sat evenings. Can you commit to 1-2 shifts per month?

Yes
No
Unsure

Please list name and contact details of 2 people who are willing to provide references for you: *

Reference 1: Name: Occupation: Address: Contact number: Reference 2: Name: Address: Occupation: Contact number

I understand that I will need to undergo Garda Vetting to volunteer at the Haven Hub and I agree to same *

I Agree

I certify that the information I have provided on this form is true to the best of my knowledge. I consent to Haven hub volunteers to use and record my personal details for this application and position

I Agree