* mandatory fields
  Salutation:   *  
  Name:   *   NRIC no.:   *  
  D.O.B. :   (dd/mm/yyyy)          
  E-mail address:   *  
  Contact no.:    *   Mobile no.:    *  
  Address:    *   Postal code:   *  
  Occupation:    
  Volunteerism experience
(if any):
   
  Religion:    
  Knowledge of languages:  
Spoken Written
English
English
Mandarin Mandarin
Malay Malay
Tamil Tamil
     
  Level of commitment:    *  
  Others
(please specify):
   
  Training request:    
   
 
Terms of agreement
a.I understand that by submitting this application, I agree to be interviewed by the volunteer co-ordinator and accept the hospital's decision on my suitability in the area of voluntary work I signed up for.
Confidentiality
a.The hospital places great emphasis on confidentiality, thus volunteers are requested not to break this code. Information on patients’ diagnosis, treatment and condition must not be released.