DRAFT Crohn's and Colitis Canada Volunteer Application Form

Full Name*

First NameLast Name
Address*
Address 2
City / Town*
Province*
Postal Code*
E-mail*
example@example.com
Phone Number *

Area CodePhone Number
Preferred Method of Communication*

E-MailPhone
Would you like to receive the “Talk about GUTS” monthly e-newsletter?

Yes, please add me. I can unsubscribe at any time.
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.
How did you learn about our volunteer opportunities?*

Crohn's and Colitis Canada website or eventCrohn's and Colitis Canada volunteer or supporterOnline volunteer posting (E.G. CharityVillage)Volunteer centre posting (E.G. Volunteer Toronto)Volunteer fairSocial Media PostMedia: radio or newspaperWorkplace or schoolOther
Which option best describes you?

EmployedRetiredSeeking employmentStudentOther
Name of Employer/School
Does your Employer/School offer any of the following:

Donations for employee volunteersMatching charitable giftsPaid time off to volunteerVolunteer fairs/internal volunteer recruitment/promotionI'm unsure
Why do you want to volunteer with Crohn's and Colitis Canada?

I have or know someone living with Crohn's or colitisCommunity Service program (high school, co-op)I'd like to share/develop my skills, expand my networkOther- please elaborate
Other/Additional Reasons:
Interested in a specific role? Please list it here along with where you saw it posted.
How do you hope to contribute as a volunteer?*
PLEASE SELECT THE VOLUNTEER OPPORTUNITIES THAT YOU ARE MOST INTERESTED IN:
Short-term & Occasional Opportunities (one day, up to 3 months, project work, as needed/available)

Event Day roleHealth 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)
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)
Are you interested in volunteering for a:*

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)
Gutsy Walk (GW) takes place annually in June. If you are interested in volunteering for GW, please let us know your nearest location:
I am fluent in the following languages

EnglishFrenchOther
If other, what language(s)?
Emergency Contact name*
Emergency Contact phone number*
Volunteer Signature*

Clear
Parent/Guardian Signature

Clear
Required for applicants 17yrs and under
Please verify that you are human*
If under 18, what year were you born?
What is your connection to Crohn's and Colitis Canada?

I have never volunteered or donated in the pastI volunteered or donated in the pastI currently volunteer or donate
What event did you volunteer for?
At Gutsy Walk, I'm interested in

an event day role ONLY (one day commitment)being an event day volunteer and maybe morebeing a committee member
Transportation

I have access to a reliable vehicleI have access to public transitI do not have my own method of transportation
Availability

Weekdays (9am-5pm)Evenings (6pm-9pm)WeekendsOpen/Changing schedule
Emergency Contact evening phone number
If under the age of 18, please obtain parental or legal guardian consent. Parent/guardian's name:
Have you ever been convicted of a criminal offense for which you have not received a pardon?

YesNo
Are you over the age of 18?

YesNo
Emergency Contact relationship (optional)
Should be Empty: