Volunteer Application Form

At Lanark County Interval House and Community Support, we believe every woman and child should live with dignity and be free from threatening situations. To accomplish our goals of protecting these women and children, we rely heavily on the help of our volunteers. We appreciate your willingness to assist LCIHCS and will strive to provide you with a rewarding experience. To become a volunteer at LCIHCS, please submit your application form including two references and your proof of full vaccination. If you have a valid police record check within the past three years, please

attach this document as well. LCIHCS will interview you at your convenience and provide you witha

letter for a police criminal record check if required. Please be advised: If you have been abused by an intimate partner, LCIHCS recommends volunteers be free from the relationship for at least two years and receive counselling prior to beginning your role with us. Any questions or concerns may be addressed to the Volunteer Coordinator. LCIHCS does not guarantee position to all applicants.

Name*

Application Date*

Date

Phone*

Alternate Phone

Email*

example@example.com

Preferred Contact Method

Mailing Address*

Birthdate DD/MM (Year not required)*

Emergency Contact Name*

Emergency Contact Phone*

Please indicate any medical or health concerns we should be aware of which may affect your ability to perform volunteer tasks and/or require accommodations such as challenges in accessibility, mental or physical health, allergies, etc.*

Do you have a valid driver's license?*

YesNo

Do you have valid CPR training?*

YesNo

What languages do you speak/write?*

I give LCIHCS permission to use my name and photograph on social media and printed publicationsI understand I must provide proof of full vaccination against COVID-19I understand I must provide a valid Police Vulnerable Sector Check and will obtain one should I not have a valid check (within the last three years)

Why would you like to volunteer at Lanark County Interval House?*

LCIHCS works from a feminist perspective. What does this mean to you?*

Please indicate which area(s) you are interested in volunteering in (job descriptions found below). Please indicate if you would be interested in hosting events for residents (weekly/monthly/bi-monthly/twice annually/annually/one off) using a special skill (music, yoga, spa night, craft night, game night, baking, etc. - you do not need to be a professional to host an event)*

Reference 1: Name*

Relationship to you*

Phone Number*

Email*

example@example.com

Reference 2: Name*

Relationship to you*

Phone Number*

Email*

example@example.com

By signing and submitting this Volunteer Application, I acknowledge that this information is true and accurate. I authorize Lanark County Interval House to obtain references from the individuals listed above. I understand any misrepresentations will be grounds for dismissal as a volunteer.

Signature

Date

Guardian Signature (If Under 18)

Date

Volunteer Roles

Volunteers will never be put in dangerous situations or abusive situations

In the Community

As Good As New Store Volunteer (Regular Shift) Customer Service (greeting and assisting customers); taking money and recording sales; sorting, steaming, and pricing donations; organizing clothing on the floor and in displays.

Picking Up/Delivering Donations (On Call) Collecting donations and delivering them to the necessary locations (As Good As New Store,shelter, etc, may include some lifting

Shelter and Program Support

General Shift Support (Day or evening shift, 4-8 hours, weekly or monthly) Assisting counselling staff, Administrative and/or shelter duties may be required.

Running activities/interacting with women

Children's Program Support (Regular Shift or On Call) Support Children's Program, Playtime, Homework help, Running/planning crafts, and activities

Volunteer Driver (On Call) Driving our clients to and from counselling sessions, appointments, etc. Must have a clean driving abstract and proper insurance. If providing own vehicle, mileage compensated.

Movers (On Call) Help women move household items and furniture to new residence. If providing own vehicle,

Grocery Shopping and Delivery (Regular Shift, Back Up Volunteers Appreciated) Collect grocery shopping weekly, residents and staff will help unload the vehicle upon arrival

Headlice Team (Very Occasional, On Call) Nit checking, vacuming, clean up

Garden/Yard Maintenance: Gardening, Spring cleans up, raking leaves, Cutting the lawn, Snow shovelling, salting

Shelter/store maintenance (minor repairs, painting, etc; lifting or moving furniture. Happy to welcome more support in this area depending on skill level

Donation Volunteers (On Call, Seasonal - Especially the Holidays) Receiving, sorting, and putting away donations; Planning for surplus donations; Assist with Holiday donations

Organizing and Maintaining Storage Rooms and Pantry (On Call, Regular Shift as Needed): Occasional assistance with keeping our shelter organized. May include assistance with organizing the linen closet, pajama and underwear supply, kitchen and pantry, winter clothing, storage areas, monitoring inventory of supplies, etc.

Administrative Support

General Office Administration (Regular Shift or On Call): Volunteers may help with mailouts (stamping, stuffing and sealing envelopes), filing and organization, writing thank you notes, or other office administration help as necessary. Proficiency with computers is an asset. Volunteers may also assist with data entry, proficiency with computers is required for this role.

Event Support (On Call)

Committee Support: Assisting with planning, create and distribute marketing materials and/or solicit auction items and sponsorships.

Day of Event Support: Volunteers will assist with day of duties such as set up, registration and clean up

Public Education/Community Event Support: Volunteers will support staff members at community events like the Farmer's Market or Maple fest. Volunteers will distribute informational materials and merchandise as well as provide the community with information on LCIHCS

Board of Directors (attend meetings and events, regular support of the agency as determined): Board members must be dedicated feminists with a strong commitment to equity, fairness, diversity, harm reduction and anti racism/oppression practices. Ideal candidates will possess a strong interest in working towards the elimination of all forms of gender-based violence, show integrity and commitment, and support the work and the mission of the organization.

Special Skills

We are always appreciative of volunteers who can use their special skills to help our clients or staff. We also love to have our volunteers host occasional "specialty nights" or activities for our residents (women and/or children) or clients.

Below are some examples of special skills we could use to support our shelter or programs, but we are always open to hearing about your special skills!

Cooking or Baking

Photography/Videography

Hairstyling/Aesthetics

Tutoring

Yoga

Music

Art

Massage Therapy

We welcome other skills you may wish to sharel Please indicate the skills when listing your preferences and speak with our Volunteer Coordinator!

We love being able to provide fun activities for our residents! It is not required that you be a professional to host a Specialty Night or Activity. Ideas include nail painting/spa/ self care day, games night, arts and crafts, etc.

Volunteer Application Form

References