NATIONAL KIDNEY FOUNDATION OF MALAYSIA
VOLUNTEER FORM
Part 1 – Terms & Conditions
I consent to undertake the services entirely at my own risk, and agree not to be eligible for compensation or any NKF benefits. I shall act in the best interest of NKF with no vested or personal interest of third parties.
I understand the services rendered may involve risk of injury and illness but any rights to bring any legal action against National Kidney Foundation of Malaysia are waived as the services are voluntary in nature and involve no monetary reward.
I will abide by the NKF policies and procedures and external regulations that govern their actions, including but not limited to those relating to ethical behavior, safety, confidentiality, protected health information and financial responsibility.
At all times, I cannot act as an employee or servant of National Kidney Foundation or enter into any agreement(s) which bind the National Kidney Foundation of Malaysia or any of its servants.
Any photographs or any materials collected during the course of my work as a volunteer, are the property of the National Kidney Foundation of Malaysia and may not be released/ used by myself or any of my agents without prior notification and permission from the National Kidney Foundation of Malaysia in writing.
The National Kidney Foundation of Malaysia reserves the right to terminate my services with or without notice.
Part II – Volunteer Information
Area of interest and service that you wish to volunteer:
1) Public Education
2) Patient Welfare
3) Fundraising
(Please choose at least one option from Public Education or Patient Welfare or Fundraising)
Remarks if any:
Volunteer Information
Name:*
Street Address:*
City:*
State:*
Please Choose one
Johor
Kedah
Kelantan
Kuala Lumpur
Melaka
Negeri Sembilan
Pahang
Penang
Perak
Perlis
Sabah
Sarawak
Selangor
Terengganu
Postcode:
Home Phone:
Office Phone:
Hand Phone:
(Please provide at least one contact number, either home, office or handphone)
E-mail Address:
Sex:*
Please Choose one
Male
Female
Age:*
Possess transport with valid licence:*
Please Choose one
Yes
No
Language spoken*
English
Bahasa Melayu
Mandarin
Tamil
Other/ Dialect
Availability:*
Time of day available*
Remarks if any:
* Compulsory field
Remarks:
1) A Certificate of Recognition will be offered subject to the contributions from the volunteer.
2) Please send or fax the completed form to the following and we will contact you as soon as possible.
National Kidney Foundation of Malaysia
Fundraising Department
70, Jalan 14/29, 46100 Petaling Jaya,
Selangor, Malaysia.
Fax: 603-7954 0535