Pivot Society Volunteer Application Form

Volunteer Application Form
Thank you for your interest in volunteering with Pivot Society. Our programs rely on committed and passionate volunteers who want to create positive change in the lives of at-risk youth and community members. Please complete this form as fully as possible.
Section A

Personal Information
Name:*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Phone Number:*
Email:*
example@example.com
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Emergency Contact Name:*

First NameLast Name
Emergency Contact Phone Number:*
Section B

Volunteer Interests
1. Which program(s) are you interested in volunteering for?*

Gloves Not Guns – Community ProgramGloves Not Guns – Correctional ProgramPivot Society (general programming, events, outreach)Other
2. In what capacity are you most interested in volunteering?*

Mentorship / One-on-One SupportProgram Facilitation (boxing, life skills, workshops)Event Support (fundraisers, community events)Administrative / Research SupportSpeaking / Lived-Experience SharingOther
3. Are you eventually looking for a paid position with Pivot Society?*

YesNoUnsure
Section C

Background & Experience
4. Why do you want to volunteer with Pivot Society?*
5. How did you hear about us?*
6. Have you worked with youth before?*

YesNo
If yes, in what capacity:
7. What skills or strengths do you bring? (check all that apply)*

Boxing / FitnessPublic SpeakingResearch / AdministrationCounseling / MentorshipCultural / Spiritual KnowledgeOther
Section D

Screening Questions
8. Do you have a criminal record?*

YesNo
9. Have you been charged with a criminal offence in the past 5 years?*

YesNo
If yes, please explain:
10. Do you currently have the following checks completed? (check all that apply)*

Criminal Record Check (CRC)Vulnerable Sector CheckIntervention Record Check
11. If not, are you willing to obtain these checks as a condition of volunteering*

YesNo
Section E

Availability & Commitment
12. What days and times are you available to volunteer?*
13. How much time are you interested in committing?*

WeeklyBi-WeeklyMonthlySpecial Events Only
14. Do you have reliable transportation to attend programming at community sites and/or correctional facilities?*

YesNo
Section F

References
Please provide at least one reference (non-family) who can speak to your character, skills, or experience:
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Applicant Declaration

I certify that the information provided above is true and complete to the best of my knowledge. I understand that submitting this application does not guarantee a volunteer placement, and that Pivot Society may conduct reference and background checks as part of the screening process.
PARTICIPANT’S SIGNATURE*

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Date Signed:*

MonthDayYear
Date
Should be Empty:

Volunteer Application Form

Section A

Section B

Section C

Section D

Section E

Section F