Volunteer Application Form

Volunteer Area

Name

Mailing Address

Postal Code

Home Phone

Cell Phone

E Mail

example@example.com

Emergency Contact Name

Emergency Contact Phone Number

Emergency Contact Name Relationship

Home phone

E Mail

example@example.com

Both

Any Medical concerns that Confederation Park 55+ Activity Centre should be aware of in case of emergencies

Would you like to receive e-mails regarding upcoming event at our Centre and upcoming volunteer opportunities?

Previous/Current Work and Volunteer Experience:

Start date

Date

End Date

Date

Which department(s)/ Position are you interested in volunteering for?

What is your avilability?

Please list any interest, hobbies or skills that may apply to your volunteer experience at our Centre

What would you like to gain through your volunteer experiences?

I hereby authorize the Volunteer Coordinators or other representatives of the Confederation Park 55+ Activity Centre to contact the persons or organizations listed below for the purpose of obtaining references

Signature

Clear

Date

Reference # 1:

Name

Relationship

Phone Number

E Mail

example@example.com

Reference # 2

Name

Relationship

Phone Number

Please enter a valid phone number.

Email

example@example.com

Applicant's Declaration Before signing, please be sure your application is filled our COMPLETELY and that you have read and understood the following declaration:

I hereby consent for the Centre to use my personal image of any photo taken during my volunteer time for the purpose of promotional, marketing and educational

1. That all statements made on this application are true and I understand that any false statements may cause termination of my volunteer position with Confederation Park 55+ Activity Centre.

2. I understand that during my volunteer work with Confederation Park 55+ Activity Centre, I may learn information that is confidential in nature. I understand and agree that I will not disclose confidential information to persons outside of the organization, unless prescribe by law. Additionally, I will only release information to existing personnel that needs to know

3. I understand that my application to become a volunteer with Confederation Park 55+ Activity Centre also includes the submission of a Criminal Record

Check, if necessary, for the position.

Applicants Signature

Clear

Date

Parent/Guardian Signature

Clear

Date

(if applicant is under 18 years old)

It is not mandatory to answer specific questions, but this information is helpful in matching a volunteer with the appropriate task. Withholding certain information may limit certain volunteer opportunities. Please be advised that the personal information you have provided herein may be used for the purpose of volunteering only, and conforms to Section 32 of the Freedom of information and Protection of Privacy Act. Revised: July 15, 2020