Volunteer Sign Up Fields marked with an * are required HTML First Name * Last Name * Gender * Male Female Nationality * Singaporean Singapore PR Foreigner If Nationality is Foreigner (please specify) Address * Postal Code * Contact Information Contact Information Email Contact Number * Other Information Other Information Trained in RP? * Yes No If trained in RP, please state date of training Do you have any history of psychological conditions (includes depression), substance abuse (includes smoking), gambling addiction or pornographic addiction ? * Yes No Have you ever been involved in domestic violence, sexual abuse or child abuse ? * Yes No Do you have any communicable diseases ? * Yes No Do you have any history of major chronic illnesses ? * Yes No Have you ever been convicted in a court of law in any country ? * Yes No Have you ever been dismissed or discharged from the services of any company ? * Yes No Have you ever received counselling or therapy to cope with your life’s issues ? * Yes No If you responded ‘yes’ to any of the questions above, please share with us your story to the extent that you are comfortable. Declaration Declaration I declare that I have given truthful and accurate information in the application form and that any false representation or omission of information may result in my application being rejected or my service being terminated upon acceptance as a volunteer. “By signing below, I consent to the collection, use, and disclosure of my personal data provided in this application form, to LCCS, LCCS’ employees and/or volunteers handling such applications, any government authorities and any other relevant parties for the purposes of processing my application and, if successful, for my engagement with LCCS.” View PDPA Applicants Acknowledgement * Yes If you are a human seeing this field, please leave it empty.
