Volunteer Cowichan Volunteer Application

Thank you for your interest in volunteering with Volunteer Cowichan and making a difference in your community! We're excited to learn more about you. The following information is collected for the purposes of delivering our volunteer services. These include our general operation, special events and our "Healthy Aging" services which help seniors continue to live independently in their homes with non-medical support. This information will remain confidential and is used to help create the best volunteer experience for you and our clients.

Please reach out if you are having trouble in completing this application by contacting our Volunteer Coordinator at volunteer@volunteercowichan.bc.ca or by phone at 250-748-2133. Regular office hours are Monday through Friday 9am -2pm.

Are you 18 years of age or older?*

YesNo

This application is for adults 18 and over. Youth 15 years of age and older are served through our Youth 2020 Can- Cowichan program. To learn more please contact youth2020cowichan@gmail.com.

Are you 80 years of age or older?*

YesNo

Our insurance provider currently only covers volunteers who are under the age of 80 years of age. If you are interested in volunteering for Volunteer Cowichan and are 80 years of age or older, please contact us directly to discuss further at 250-748-2133.

Name*

First NameLast Name

Preferred First Name

Phone Number*

Area CodePhone Number

Cell Number

Area CodePhone Number

Email

example@example.com

Preferred Method of Contact:*

PhoneCellEmail

Address*

Street Address

#Apartment/Suite/Unit

CityProvince

Postal Code

Emergency Contact:

What Languages do you speak:*

Which area of the Cowichan Valley would you most like to volunteer? If you are open to volunteering in multiple communities, please check all that apply.*

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VOLUNTEER APPLICATION