DRAFT Crohn's and Colitis Canada Volunteer Application Form

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Full Name* This field is required.
First Name
Last Name
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Address* This field is required.
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Address 2
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City / Town* This field is required.
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Province* This field is required.
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YK
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Postal Code* This field is required.
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E-mail* This field is required.
example@example.com
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Phone Number * This field is required.
Area Code
Phone Number
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Preferred Method of Communication* This field is required.
E-Mail
Phone
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Would you like to receive the “Talk about GUTS” monthly e-newsletter?
Yes, please add me. I can unsubscribe at any time.
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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 any time.
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How did you learn about our volunteer opportunities?* This field is required.
Crohn's and Colitis Canada website or event
Crohn's and Colitis Canada volunteer or supporter
Online volunteer posting (E.G. CharityVillage)
Volunteer centre posting (E.G. Volunteer Toronto)
Volunteer fair
Social Media Post
Media: radio or newspaper
Workplace or school
Other
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Which option best describes you?
Employed
Retired
Seeking employment
Student
Other
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Name of Employer/School
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Does your Employer/School offer any of the following:For more information on the Employer matching charitable gifts option copy/paste: https://crohnsandcolitis.ca/Ways-to-Give/Employer-Matching-Gifts
Donations for employee volunteers
Matching charitable gifts
Paid time off to volunteer
Volunteer fairs/internal volunteer recruitment/promotion
I'm unsure
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Why do you want to volunteer with Crohn's and Colitis Canada?
I have or know someone living with Crohn's or colitis
Community Service program (high school, co-op)
I'd like to share/develop my skills, expand my network
Other- please elaborate
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Other/Additional Reasons:
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Interested in a specific role? Please list it here along with where you saw it posted.
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How do you hope to contribute as a volunteer?* This field is required.
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PLEASE SELECT THE VOLUNTEER OPPORTUNITIES THAT YOU ARE MOST INTERESTED IN:
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Short-term & Occasional Opportunities (one day, up to 3 months, project work, as needed/available)
Event Day role
Health promotion (education, displays, public speaking)
Group volunteering (corporate, faith, workplace, school, service club)
Committee role (planning Crohn's and Colitis Canada's fundraising and educational events)
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Longer-term & Regular Opportunities (6 months - 1 year or more, weekly or a few times a month)
Being a leader in my community (leading a team of volunteers)
Event planning & fundraising (leadership role overseeing sponsorship, planning, event day)
Marketing & communications (social media, promotion, writing)
Volunteer engagement (recruitment, screening, recognition)
Virtual/off-site roles (working online, requires a strong internet connection)
Gutsy Walk leadership (annual event taking place in June)
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Are you interested in volunteering for a:* This field is required.
Short-term basis (one day, up to 3 months)
Longer-term basis (6 months- 1 year or more)
Occasional (project work, as needed/available)
Regularly (weekly or a few times a month)
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Gutsy Walk (GW) takes place annually in June. If you are interested in volunteering for GW, please let us know your nearest location:
Abbotsford
Athabasca
Amherst
Banff/Canmore
Battlefords
Bridgewater
Calgary
Collingwood
Corner Brook
Cranbrook
Durham Region
Eastern Avalon (St. John's)
Edmonton
Estrie (Sherbrooke)
Exploits Valley
Fraser Valley West (Surrey/Langley)
Fredericton
Gander
Grand Falls
Grande Prairie
Gravenhurst
Grey Bruce
Halifax
Halton Region
Hamilton
Kamloops
Kelowna
Kingston
Kitchener/Waterloo
Langley (Surrey/Fraser Valley West)
Lethbridge
Lloydminster
London
Mauricie
Medicine Hat
Moncton
Montérégie
Montréal
Nanaimo
Niagara
Ottawa / Gatineau
Peel Region
Peterborough
Pictou County
Prince Albert
Prince Edward Island (Rustico)
Quebec City
Red Deer
Regina
Rustico (PEI)
Saint John
Sarnia
Saskatoon
Sault Ste. Maire
Sherbrooke (Estrie)
Simcoe County
St. John's (Eastern Avalon)
Strathroy
Sudbury
Surrey/Langley
Swift Current
Sydney
Thompson
Toronto
Trinity Conception
Upper Trinity South
Vancouver
Vernon
Victoria
Westman
Windsor
Winnipeg
York Region
Yorkton
Other
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I am fluent in the following languages
English
French
Other
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If other, what language(s)?
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Emergency Contact name* This field is required.
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Emergency Contact phone number* This field is required.
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Volunteer Signature* This field is required.
Clear
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Parent/Guardian Signature
Clear
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Please verify that you are human* This field is required.
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If under 18, what year were you born?
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
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What is your connection to Crohn's and Colitis Canada?
I have never volunteered or donated in the past
I volunteered or donated in the past
I currently volunteer or donate
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What event did you volunteer for?
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At Gutsy Walk, I'm interested in
an event day role ONLY (one day commitment)
being an event day volunteer and maybe more
being a committee member
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Transportation
I have access to a reliable vehicle
I have access to public transit
I do not have my own method of transportation
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Availability
Weekdays (9am-5pm)
Evenings (6pm-9pm)
Weekends
Open/Changing schedule
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Emergency Contact evening phone number
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If under the age of 18, please obtain parental or legal guardian consent. Parent/guardian's name:
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Have you ever been convicted of a criminal offense for which you have not received a pardon?
Yes
No
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Are you over the age of 18?
Yes
No
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Emergency Contact relationship (optional)
Should be Empty: