1 IN 2
IS TOO MANY

1 in 2 of us will be diagnosed with cancer by age 85.
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Cancer Connect Volunteer Application

Thank you for your interest in volunteering with the Cancer Connect peer support program.

We ask that applicants completed their cancer treatment a minimum of two years and a maximum of five years ago*. 

This timeframe allows volunteers to be physically and psychologically prepared for the supportive role they undertake, while ensuring their treatment experience remains relevant.

*This timeframe is flexible and applicants will be assessed on a case-by-case basis, considering the nature of their treatment and diagnosis.

We recognise that not everyone will fit these parameters, e.g. those on maintenance therapy or with stable metastatic disease.

The following form requests detailed information about your cancer experience. We capture this so we have a good understanding of your cancer diagnosis and treatment so we can best match you with people that are going through a similar cancer experience.

Before completing the form:

  • The form may take up to 30 minutes to complete. 
  • Please read the form carefully and make sure you have all of the information ready before you start filling it out as you won't be able to save and come back later.
  • If you need help with any of the questions please contact the Cancer Connect Manager on 03 9514 6315 

 

Contact details


Your diagnosis and treatment summary (please complete to the best of your knowledge)

Please attach documentation to verify cancer diagnosis (i.e. doctor's letter or report)

Breast cancer applicants only







Please tick the type of treatment(s) you have had and provide further details on treatment type:


Further information


Referee

Please note all successful applicants will be subject to a Police Check

By completing this form, you have provided Cancer Council Victoria with your personal information, which includes your sensitive and health information.

We will use and disclose this information for the purpose of reviewing your eligibility for the Cancer Connect program and matching you with suitable participants in the program.

Cancer Council’s Privacy Policy and Collection Statement contains general information about how we will handle and hold your personal information, and how you can contact us to seek to access or correct your personal information or make a complaint.  You should review this Privacy Policy and Collection Statement to ensure you are fully informed about these matters.   

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