Online Volunteer Registration Form

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If you prefer to submit a hardcopy of the volunteer application form, please email your request to mlaw_hq_cmc@mlaw.gov.sg. The volunteer registration form will then be emailed to you.

Tertiary students and youth below the age of 25 who have undertaken or are completing a mediation-related course may apply to CMC's Mediation Aides Programme by contacting us at mlaw_hq_cmc@mlaw.gov.sg

Personal Details

NRIC No. *

Name in Chinese Characters (If Applicable)

Salutation:*

Dr
Mr
Miss
Mdm

Name:*

Sex: *

Male
Female

Date of Birth

Marital Status: *

Single

Married

Widowed

Divorced/Separated

Home Address:*

Block No. Unit No.

Street/Building Name: *

Postal Code: *

Constituency/CDC:

Country of Birth:

Nationality: *

Singaporean

Permanent Resident

Others, please specify

Race: *

Chinese

Malay

Indian

Eurasian

Others, please specify

Religion: *

Buddhism

Hinduism

Islam

Free Thinker

Others, please specify

Highest Educational Level: *

Contact Details

Preferred Contact No. *

Alternative Contact No.

Fax No.

Details of Mediation Courses attended (if any)

(Kindly provide copies of certificates)

Name of Course and Organiser	Date Attended

Language Proficiency (inclusive of dialect)
Spoken *
Language 1	FluentGoodBasic
Language 2	FluentGoodBasic
Language 3	FluentGoodBasic
Written *
Language 1	FluentGoodBasic
Language 2	FluentGoodBasic
Language 3	FluentGoodBasic

Occupation
Occupation *
Name of Employer/Company

Community Services (if any)
Organisation	Position	Start Date	End Date

Voluntary Commitment, preferred time slots: Morning (0900 - 1300hrs), Afternoon (1400 - 1700hrs) and Evening (1800 - 2100hrs)
Monday	Morning Afternoon Evening	Tuesday	Morning Afternoon Evening	Wednesday	Morning Afternoon Evening
Thursday	Morning Afternoon Evening	Friday	Morning Afternoon Evening	Saturday	Morning

Please explain why you would like to volunteer with the CMC *

Please tick the appropriate box. If 'Yes' please give details in the space below.


1. Have you ever been charged with any offence or convicted by any Court or detained by the authorities under the provisions of any law in any country? (excluding parking offenses)* YesNo Details (if any):
2. Are you aware of any current police investigation in any country following allegations made against you?* YesNo Details (if any):

3. Are you currently under any financial embarrasment, ie (a) an undischarged bankrupt, (b) a judgement debt (c) have unsecure debts and liabilities of more than 3 months last-drawn pay, (d) have signed a promissory note or an acknowledgement?* YesNo Details (if any):
I understand by submitting this application I have declared in effect that all information all contained in this application is true to the best of my knowledge and that I have not withheld any relevant particulars.

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