Volunteer Application

Volunteer Application

Thank you for your interest in volunteering with us! Please fill out the form below to help us understand how you'd like to contribute.
Date

MonthDayYear
Date
Name*

First NameLast Name
Address

Street Address

Apartment Unit

CityState / Province

Postal / Zip Code
Birthday (Date and Month only)
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Cell
Work
Email*
example@example.com
Emergency Contact
Emergency Contact Name
Phone Number
Format: (000) 000-0000.
Relationship
What is your reason for wanting to volunteer?

Spare TimeWork RelatedSchool RequirementExplore Career OpportunitiesDevelop SkillsCommunity InvolvementPersonal SatisfactionDesire to Help OthersOther
Why have you chosen to volunteer at Good Shepherd?
How did you learn about volunteering at Good Shepherd? Check all that apply.

Social MediaVolunteer CentreNewsletter/mailingPosterFriendChurchWebsiteSpecial EventAnother volunteerOther
What is the highest level of education you completed (optional)
Name of School
Program
Graduated Year (if Applicable)
Have you ever used the services or programs of Good Shepherd?

YesNo
If so, where?
When?
8. Have you ever been employed by Good Shepherd?

YesNo
9. Are you currently employed?

YesNoStudent
If employed – Employer
PTFT
Primary duties
10.Are you currently volunteering?

YesNo
Where?
How long?
Duties

Past volunteer experience (if Any):

Rows	Year started	Length of service	Organization	Position
1
2
3

Languages spoken fluently other than English
Hobbies or skills
Please list the Centers or positions you are interested in i.e. Women’s Services, Family Centre or Child Minding, Cooking, Food Bank
What time commitment are you looking for? (8-12 months, 1 year plus, other)
Are you 13-17 years of age?

YesNo
Are you 18 years of age?

YesNo
Are you 19 years of age or older?

YesNo

When is your available volunteer time?

Rows	Yes	No
Daytime
Evening ( after 5PM)
Weekend

Do you have a current Criminal Record Check or Vulnerable Sector Check?
Personal References

Please have 2 references complete the reference form located on the Volunteer Page of our website
Declaration of Accuracy of Information and release of Information authorization

I hereby, certify that the facts set forth in the above Volunteer Application are true and complete to the best of my knowledge. I understand that if placed, falsified statements on this Application Form may disqualify me from my volunteer involvement or become just cause for my dismissal and there shall not be any claims made against Good Shepherd or any further legal obligation placed on Good Shepherd as a result of having taken such action. This further authorizes Good Shepherd to make any inquiries usually required to determine my suitability for volunteer placement as well as to contact any references and/or others to release to Good Shepherd any information which will assist Good Shepherd to determine my suitability for volunteer placement. I acknowledge and accept that this application does not guarantee acceptance into the program, and that Good Shepherd is under no obligation to accept or assign me as a volunteer in their program, and is not obliged to provide a reason.
Date

MonthDayYear
Date
Signature
Signature of Parent/Guardian (if under 16)
Volunteer Permission and Release Form

I hereby authorize Good Shepherd to contact any or all of the references submitted for the purposes of processing my application to become a volunteer at one of the Good Shepherd Centres. I understand that these references will be contacted in confidence. I hereby waive the right to request disclosure of the personal references given about me. Good Shepherd reserves the right to request more references.

I further authorize the Police Department to release information to Good Shepherd in order to consider my application to volunteer in the programs of Good Shepherd, on the understanding that such information will be held in strict confidence.

I acknowledge and accept that this application does not guarantee acceptance into the program, and that Good Shepherd is under no obligation to accept or assign me as a volunteer in their program, and is not obliged to provide a reason.

I hereby release and forever discharge Good Shepherd, and their employees, directors and volunteers from any cause of action or claim for damages, whether bodily injury, death, property damage, or emotional trauma, anxiety or distress arising from my association with Good Shepherd.

I give permission to the Good Shepherd Volunteer Department to release pertinent information regarding my file to the Director or Program Coordinator/Supervisor of the program to which I am applying to in order to be considered for acceptance into the program.

I understand this application and subsequent information in my file is the property of Good Shepherd.

I understand the implications of this waiver and consent to them. I further agree that this waiver is made of my own free will and without duress.
Printed Name
Date

MonthDayYear
Date
Signature
Should be Empty:

Volunteer Application

Emergency Contact