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Register Your Interest in Volunteering at Eldercare

Please fill in the form below to register your interest in volunteering at Eldercare.

Please note from 1 July, volunteers are welcome back at sites with some restrictions. Contact the Volunteer Program Coordinator on (08) 8291 1000 for more information.

required = required

array (
  'field text f162' => 
  C1Field::__set_state(array(
     '_p' => 
    array (
      'name' => 'fields[162]',
      'label' => 'Name',
      'type' => 'Text',
      'default' => '',
      'required' => true,
    ),
  )),
  'field text f163' => 
  C1Field::__set_state(array(
     '_p' => 
    array (
      'name' => 'fields[163]',
      'label' => 'Address',
      'type' => 'Text',
      'default' => '',
    ),
  )),
  'field text f164' => 
  C1Field::__set_state(array(
     '_p' => 
    array (
      'name' => 'fields[164]',
      'label' => 'Suburb',
      'type' => 'Text',
      'default' => '',
      'required' => true,
    ),
  )),
  'field phone f165' => 
  C1Field::__set_state(array(
     '_p' => 
    array (
      'name' => 'fields[165]',
      'label' => 'Phone Number',
      'type' => 'phone',
      'default' => '',
      'required' => true,
    ),
  )),
  'field reply-to-email f166' => 
  C1Field::__set_state(array(
     '_p' => 
    array (
      'name' => 'fields[166]',
      'label' => 'Email Address',
      'type' => 'Email',
      'default' => '',
      'required' => true,
    ),
  )),
  'field select f167' => 
  C1Field::__set_state(array(
     '_p' => 
    array (
      'name' => 'fields[167]',
      'label' => 'Preferred Site',
      'type' => 'Select',
      'default' => '',
      'required' => true,
      'options' => 
      array (
        '' => '',
        'Acacia Court, Hendon' => 'Acacia Court, Hendon',
        'Allambi, Glengowrie' => 'Allambi, Glengowrie',
        'Cottage Grove, Woodcroft' => 'Cottage Grove, Woodcroft',
        'Evanston Park' => 'Evanston Park',
        'Head Office, Eastwood' => 'Head Office, Eastwood',
        'Oxford, Hove' => 'Oxford, Hove',
        'Sash Ferguson, Mt Barker' => 'Sash Ferguson, Mt Barker',
        'Seaford' => 'Seaford',
        'South Park, Minlaton' => 'South Park, Minlaton',
        'The Lodge, Wayville' => 'The Lodge, Wayville',
        'The Village, Maitland' => 'The Village, Maitland',
        'Trowbridge House, Payneham' => 'Trowbridge House, Payneham',
      ),
    ),
  )),
  'field textbox f168' => 
  C1Field::__set_state(array(
     '_p' => 
    array (
      'name' => 'fields[168]',
      'label' => 'Skills or interests you would like to use whilst volunteering at Eldercare e.g. gardening, cooking',
      'type' => 'Text Area',
      'default' => '',
      'required' => true,
    ),
  )),
)