Contact Information
Full Name
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First Name
Last Name
Address
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Address 2
City / Town
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Province
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Please Select
AB
BC
MB
NB
NL
NS
ON
PE
QC
SK
NT
YK
Postal Code
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E-mail
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example@example.com
Phone Number
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-
Area Code
Phone Number
Which of Canada's official languages do you feel most comfortable communicating in (written and oral)? Please check all that apply.
English
French
Other
Please list the other languages you feel comfortable communicating in below.
Which role(s) are you interested in continuing in and/or starting? Check all that apply.
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Digital Peer Community Moderator
Digital Peer Community Mentor
Online Peer Support Meeting Facilitator (Canada-wide)
Gutsy Learning Series- Lead Community Education Volunteer (Canada-wide)
Do you have any professional experience or training that may be relevant to this role? (Examples: Mental Health First Aid, NVPCI, Life Skills Coaching)
What positive change do you aim to make in this role? For instance, do you aspire to provide support to those who have recently been affected by IBD?
What skills are you looking to develop or improve in this role? (Examples: facilitation, leadership, communication)
Why are you interested in volunteering as part of our Peer Support Community?
Do you have any previous formal or informal experience providing peer support or mentorship to others?
Yes
No
Could you please tell us more about your previous experience providing one-on-one peer support or mentorship to others?
Do you have any previous formal or informal experience with online moderating?
Yes
No
Tell us more about your previous experience with online moderation
Do you have any previous formal or informal experience with facilitating groups?
Yes
No
Tell us more about your previous experience with facilitating groups
Which of the following option best describes you?
Currently Employed
Seeking Employment
Student
Retired
Other
Does your Employer/School offer any of the following:
Donations for employee volunteers
Matching charitable gifts
Paid time off to volunteer
Volunteer fairs/internal volunteer recruitment/promotion
I'm unsure
Name of Employer/School
How did you learn about these volunteer opportunities?
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Crohn's and Colitis Canada's website
Crohn's and Colitis Canada Event
Word of mouth or referral (e.g., Crohn's and Colitis Canada volunteer or supporter, Crohn's and Colitis Canada staff member)
Online volunteer posting (e.g., Charity Village)
Volunteer centre posting (e.g., Volunteer Toronto)
Volunteer fair
Social media post
Media: radio or newspaper
Workplace or school
Other
Preferred method of communication
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E-Mail
Phone
Would you like to receive the "Talk About GUTS" monthly e-newsletter?
Yes, please add me. I can unsubscribe at any time.
Would you like to receive e-newsletters about Crohn's and Colitis Canada events and activities in your local community?
Yes, please add me. I can unsubscribe at anytime
Volunteer Signature
Please verify that you are human
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