Volunteer Application Form
Name
*
First Name
Last Name
Preferred pronouns
She/her
He/him
They/them
Other
Phone Number
*
E-mail
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Person to notify in case of emergency
Contact Name
*
Full name
Relationship to you
*
Contact Email
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Tell us about yourself
Your Family Doctor
*
Doctor Phone Number
*
Please enter a valid phone number.
Where are you most interested in volunteering? You can select more than one option.
*
Senior Center
Special events
Kindred ReBuild
General (willing to go where needed the most)
What inspired you to seek a volunteer position with inclusion powell river?
*
What interests or skill would you like to share in a volunteer capacity
*
Do you have any medical or other conditions that could impact you in a volunteer placement?
*
When are you available to volunteer?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Flexible
What type of placement are you seeking?
*
Weekly
Monthly
Once in a while
How long can you commit to volunteering?
*
6 months
1 year
Ongoing
Please describe any relevant volunteer or work experience you have
Please list any additional training or certificates you have that might be relevant
Please list the names and contact information for two personal references
Reference Name
*
Full name
Relationship
*
Email
*
Phone Number
*
Please enter a valid phone number.
Reference Name
*
Full name
Relationship
*
Email
*
Phone Number
*
Please enter a valid phone number.
*
I understand that this application warrants a criminal record check and may involve a verification of my motor vehicle record. By checking this box, I agree to comply with these requirement.
Would you like to receive semi-regular email updates from us?
Yes, I'd love to hear from you!
Please verify that you are human
*
save for later
submit your application
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