Have you had any experience, personal or loved one, with cancer? - Select - Yes No
How Long Ago was it? - None - Ongoing 0-6 months 6-12 months 1-2 years 2-5 years 5+ years
What skills and experience would you bring to the role?
We are committed to being inclusive for all, including people with disabilities or illnesses. Do you require any additional support or accommodations? If yes, please set out details below.
Do you hold a clean driving license? - Select - Yes No
Are you a car owner? - Select - Yes No
Do you have comprehensive car insurance? - Select - Yes No
What Hospitals are you willing to Drive to? Please ensure you choose the hospital you are willing to drive to. Please note that while we welcome every application, we will be recruiting new drivers based on the needs of each hospital. Please check the top of this form for a list of our highest-priority regions. We do try to contact every applicant but in some cases this may not be possible. Thank you again for your interest.
What hospitals are you willing to drive to? Please note that while we welcome every application, we will be recruiting new drivers based on the needs of each hospital. Please check the top of this form for a list of our highest-priority regions. We do try to contact every applicant but in some cases this may not be possible. Thank you again for your interest Beaumont Hospital, Dublin
Cavan General Hospital, Cavan, Co Cavan
Connolly Hospital, Blanchardstown, Dublin 15
Cork University Hospital, Wilton, Co. Cork
Galway University Hospital, Newcastle Road, Galway
Kerry General Hospital, Tralee, Co Kerry
Letterkenny General Hospital, Letterkenny, Co. Donegal
Naas Hospital, Naas, Co. Kildare
Mater Misericordiae University Hospital, Eccles St. Dublin 7
Mercy Hospital, Grenville Place, Cork
Merlin Park Hospital, Galway
Mayo General Hospital, Westport Road, Castlebar, Co. Mayo
Midlands Regional Hospital, Arden Road, Tullamore, Co. Offaly
Our Lady of Lourdes Hospital, Drogheda
Portiuncula Hospital, Ballinasloe, Co. Galway
Sligo General Hospital, The Mall, Sligo
South Infirmary Hospital, Cork
South Tipperary Hospital
St. James' Hospital, James' Street, Dublin 8
St. Lukes General Hospital, Freshford Road, Kilkenny
St. Vincent's University Hospital, Elm Park, Dublin 4
Tallaght Hospital, Tallaght, Dublin 24
University Hospital Limerick, Dooradoyle, Limerick, Co. Limerick
University Hospital Waterford, Dunmore Road, Waterford
Wexford General Hospital, Newtown Road, Co. Wexford
Beaumont Hospital, Dublin
Cavan General Hospital, Cavan, Co Cavan
Community Intervention Team, Glasnevin, Dublin
Connolly Hospital, Blanchardstown, Dublin 15
Cork University Hospital, Wilton Co Cork
Galway University Hospital, Newsastle Road, Galway
Kerry General Hospital, Tralee, Co Kerry
Letterkenny General Hospital, Letterkenny, Co Donegal
Naas Hospital, Naas, Co Kildare
Mater Misericordiae University Hospital, Eccles St. Dublin 7
Mercy Hospital, Grenville Place, Cork
Merlin Park Hospital, Galway
Mayo General Hospital, Westport Road, Castlebar, Co Mayo
Midlands Regional Hospital, Arden Road, Tullamore, Co Offaly
Our Lady of Lourdes Hospital, Drogheda
Portiuncula Hospital, Ballinasloe, Co Galway
Sligo General Hospital, The Mall, Sligo
South Infirmary Hospital, Cork
South Tipperary Hospital
St. James' Hospital, James' Street, Dublin 8
St. Lukes General Hospital, Freshford Road, Kilkenny
St. Vincent's University Hospital, Elm Park, Dublin 4
Tallaght Hospital, Tallaght, Dublin 24
University Hospital Limerick, Dooradoyle, Limerick, Co Limerick
University Hospital Waterford, Dunmore Road, Waterford
Wexford General Hospital, Newtown Road, Co Wexford
All volunteers are asked to commit at least 2 days a month to driving for the Volunteer Driver Service. Are you able to commit 2 days a month?
- Select - Yes No
Volunteered Previously please give details – time period and position
Social Media Inerested In Familiar With please give details – time period and position
Please provide contact details for two referees who are not related to you. We will be checking all references for volunteers. Please ensure to give direct contact details for your referees, not general contact details for companies or organisations.
Please provide us with names of two referees who are happy to give you a character reference. e.g. neighbours, previous employers, friends, etc. who are not family members, you have known for over 2 years. Please note your referees will be contacted before you start as a volunteer with us.
Reference 1: Name
Reference 1: Phone
Reference 1: Email
Relationship to you / In what capacity do you know them
Reference 2: Name
Reference 2: Phone
Reference 2: Email
Relationship to you / In what capacity do you know them