YOUTH VOLUNTEER APPLICATION FORM

INDIVIDUAL YOUTH VOLUNTEER APPLICATION FORM

Please complete this form if you are ages 15 to 17 and interested in the BGC Winnipeg Youth Volunteer Program.
Applicants need to ensure you have a correct email address for correspondence and application processing.

Youth volunteers require a Child Abuse Registry (C.A.R.) check clearance in Manitoba (only). There is no cost for youth volunteers to get the check completed. BGC Winnipeg (BGCW) needs a copy of two pieces of government identification (driver’s license, Manitoba identification card (MPI), passport, health card, social insurance card, birth certificate, status card, or permanent resident card). Youth can pick up a Child Abuse Registry (C.A.R.) check form from BGC Winnipeg head office at 300-61 Juno Street (Monday to Friday between 8:30 am to 4:00 pm) or from your local BGC Winnipeg Club Manager. Please note that it will take 4 to 6 weeks for it to be processed.

Two references can be in the form of a written letter that is dated within the last year from a neighbor, employer, teacher, volunteer supervisor, counselor or coach. Family members cannot be references.
CONTACT INFORMATION
First Name*
Last Name*
Title
Nickname
Date of Birth*

MonthDayYear
Date
Your Age Group

14-1516-17
Gender
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Home Phone Number
Please enter a valid phone number.
Okay to call me here
Work Phone Number
Please enter a valid phone number.
Okay to call me here
Cell Phone Number
Please enter a valid phone number.
Okay to call me here
PERSONAL INFORMATION

Please help us learn more about you. We would like to know if you are needing volunteer hours as part for academic credit, or just because you want to be part of our community.
BGCW Alumnus

I am a BGCW alumnus
Dates and years I attended BGCW
Club(s) I attended
Siblings or family members who attend BGC Winnipeg (First and Last Names)
Reason for volunteering

Just to Help OutCredit for SchoolLead Up Volunteer ProgramHope to Gain EmploymentAll of the Above
If for a course credit, please identify the program or course:
Name of School
Grade
Driver’s License

I have a valid driver’s license
Driver's License Class
Languages (Spoken)
Languages (Written)
EMAIL PREFERENCES

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.
Email Address
example@example.com
What kinds of email would you like to receive?

Electronic NewslettersRecruitment AppealsRequired Communications
ADDITIONAL INFORMATION

To better understand the demographics of BGC Winnipeg volunteers, please let us know some of your background.
Do you identify as any of the following?

First NationsMetisInuitVisible MinorityCame to Canada as an ImmigrantCame to Canada as a Refugee
EMPLOYER INFORMATION

Please list your current or most recent employer, if applicable.
Employer
Address

Street Address

Street Address Line 2

CityProvince

Postal Code
List last two jobs:
Employer, Start Date, End Date
VOLUNTEER EXPERIENCE

Your previous experience is worth recognizing. Please list your volunteer work below.
Organization/Institution, Volunteer Position, Duties, Dates (Start & End/Month & Year)
HOBBIES AND INTERESTS
Please identify your leisure activities and hobbies below.
What type of volunteering are you interested in?

ClubsOfficeCommunity School Investigators (CSI) Summer Learning Day Camps for KidsCSI Food CoordinatorTutoring/Mentoring (6 to 12 year olds)Community Group Volunteer ProjectsSpecial EventsOther
AVAILABILITY FOR VOLUNTEER WORK

Please note if you are hoping to work directly with children and youth during the school year almost all positions are in the afternoon or evening. In the summer we run daytime programming. Some special events are during the daytime or evenings.
Please indicate which days of the week you are available and whether it is in the morning, afternoon or evening:
Preferred Seasons to Volunteer:

Fall: September to DecemberWinter: January to MarchSpring: April to JuneSummer: July to AugustAll Seasons
REFERENCES

Please provide two references. Examples of good references are employers, volunteer supervisors, coaches and teachers. You can use a former co-worker or neighbour as a reference too. Do not use family members.
Reference 1 First Name
Reference 1 Last Name
Reference 1 Home Phone Number
Please enter a valid phone number.
Reference 1 Work Phone Number
Please enter a valid phone number.
Reference 1 Email Address
example@example.com
Reference 1 Relationship
Reference 2 First Name
Reference 2 Last Name
Reference 2 Home Phone Number
Please enter a valid phone number.
Reference 2 Work Phone Number
Please enter a valid phone number.
Reference 2 Email Address
example@example.com
Reference 2 Relationship
EMERGENCY CONTACT

In the event of an emergency whom should we notify?
Emergency Contact 1 First Name
Emergency Contact 1 Last Name
Emergency Contact 1 Home Phone Number
Please enter a valid phone number.
Emergency Contact 1 Work Phone Number
Please enter a valid phone number.
Emergency Contact 1 Email Address
example@example.com
Emergency Contact 1 Relationship
Emergency Contact 2 First Name
Emergency Contact 2 Last Name
Emergency Contact 2 Home Phone Number
Please enter a valid phone number.
Emergency Contact 2 Work Phone Number
Please enter a valid phone number.
Emergency Contact 2 Email Address
example@example.com
Emergency Contact 2 Relationship
GUARDIAN CONSENT

In order for Youth Volunteers ages 14 to 17 to become registered with BGC Winnipeg, we require the approval and consent of the parent or legal guardian below:
I acknowledge that I have reviewed the following:

1. My child will work in an environment with children ages 6 to 12.
2. My child will occasionally work off site at a community event, charity or project.
3. My child may ride in a public bus to a Club, event, field trip or charity.
4. My child may be transported by an approved agency driver in their car or a BGCW van.
5. My child may work in an environment that can be wet, hot, cold, or dusty.
6. My child may be contacted by cell, email or a meeting platform like Zoom by screened BGCW staff for volunteer, program, scholarship/bursary or project related activities.
I acceptI decline
MEDIA CONSENT
I hereby give BGC Winnipeg and/or its member Clubs consent to use and reproduce my child's name/image/likeness for promotional purposes related to BGC Winnipeg, its member Clubs and/or external partners. Their full name/image may be published or used in newspapers, promotional videos, television commercials, program brochures, posters on World Wide Web or otherwise displayed to the public or used for other promotional/educational/fundraising purposes, either in whole or in part by BGC Winnipeg, its member Clubs, and or/external partners.
I release BGC Winnipeg and its agents from any and all claims, of any nature, based on any uses of the above.*

I acceptI decline
CONFIDENTIALITY POLICY
DEFINITIONS
1. Staff - Full time, part time or contract employees of BGC Winnipeg.
2. Volunteers - BGC Winnipeg volunteer are persons who have been screened and are formally approved and assigned as volunteers and are not receiving any compensation in terms of course credit or payments for their efforts.
3. Students - BGC Winnipeg defines a student as a person who receives some form of compensation for their unpaid work. The compensation may be in terms of a course credit or monetary gain from an external organization.
BGC Winnipeg staff, volunteers, and students shall protect the confidentiality of all information regarding members/participants and their families. The obligation to maintain confi dentiality continues indefinitely after staff, volunteer or student has ceased contact with the Club member/participant or has ceased association with BGC Winnipeg. Any information shared is done only with others involved professionally with members and participants, and is done in a manner consistent with ethical and professional practice and only when it serves the best interest of the participant or is required to protect the well being or safety of others, or as required by law.

I, the undersigned, declare that I have read and understand the preceding BGC Winnipeg Confidentiality Policy and agree:
1. To conduct my assigned duties in a professional, fair and impartial manner. Any unethical or questionable behaviour (falsifying records, not acting in the best interest of the Clubs’ members, breach of the Confidentiality Policy etc.) may result in disciplinary action, up to and including termination of employment/association.
2. That the content of files, forms, brochures, books, materials, written correspondence, memorandum, documents, manuals, computer files, software products, and lists (funders, membership, mailing lists, etc.) pertaining to the operation of BGC Winnipeg shall at all times remain the property of BGC Winnipeg.
3. That, upon termination of my placement/association for any reason, all Agency property in the possession of, or directly or indirectly in my control shall be immediately returned to BGC Winnipeg. I further agree not to make for my personal or business use or that of any other party, reproductions or copies of any such property or other property of BGC Winnipeg.
4. Not to divulge to others (whether during or after my employment/association with BGC Winnipeg) and not use for my own benefit any information obtained during the course of my association with BGC Winnipeg or its membership without first obtaining the written permission of BGC Winnipeg.
I understand that BGC Winnipeg reserves the right to take disciplinary measures, which could include termination of employment/association, for breach of any of the above conditions.*

I acceptI decline
POLICY: DECLARATION OF STAFF, VOLUNTEER AND STUDENTS CONDUCT
Staff, volunteers and students behaviour towards program participants, other staff, volunteers and students, and the community at large must be exemplary.

REASON FOR POLICY:

Agency positions require staff, volunteers and students to assume the responsibilities of professional ethics and public trust, modeling the role of healthy adults with participants, some who have had negative experiences with significant adults.

It is essential that staff, volunteers and students behaviour reflect the professional standards of care, skill and diligence normally exercised and observed by persons engaged in the performance of similar social services.

PROCEDURES:
1. Abusive Behaviour
  At no time will staff, volunteers and students participate in, or permit to occur, any wilful behaviour intended to degrade, humiliate, intimidate, hurt or terrify any program participants, staff, volunteers or students.
2. Complaints Against Staff /Volunteers/Students
  Complaints against the behaviour of staff, volunteers and students by program participants or members of the public are to be resolved as openly, courteously and quickly as possible. If the situation cannot be resolved in a timely manner, a third party mediator can be brought in to help mediate the situation.
3. Not Alone Protocol
  Staff, volunteers and students should make every effort to ensure they are not alone with a participant. When staff, volunteers and students must work one-on-one with a member, they should always inform a supervisor or a colleague of their whereabouts. Staff, volunteers and students should take precautions, for example leaving a door open when having a private discussion with a participant, asking a staff, volunteers and students to sit in on a meeting, and dropping off participants of the opposite sex first from outings.
4. Non-Program Activities
  Due to the possibility of being accused falsely of inappropriate behaviour and to aid in stress management, staff, volunteers and students are discouraged from becoming involved in non-program activities with program participants. This includes giving out email addresses, home addresses, telephone numbers or contacting or responding to participants via social networking sites, such as Facebook, Twitter, Instagram, etc. When staff, volunteers and students do have contact with member(s) during non-program times, for example visiting a member in the hospital/ attending a graduation ceremony etc., they must continue to practice professionalism. Staff, volunteers and students must also inform their immediate supervisor of the contact and document the outreach activity in the daily log.
5. Socializing
  Staff, volunteers and students are to avoid socializing on a personal level, outside of program time, with program participants (even if they are legally adults) and their families as these situations have the strong potential for staff, volunteers and students behaviour to be interpreted in a negative light and, thereby, affect the professional standing of the staff, volunteers and students and the program itself. At times, staff, volunteers or students may naturally come into contact with program participants or their families outside of program time. When this happens, it is important that staff, volunteers and students not initiate contact with the participant, but rather only respond to the participant should they initiate contact. Please note that this incidental contact in public excludes contact with members at social networking sites, text messages, and on-line instant messaging.
6. Media
  The President and CEO is the exclusive designated liaison with the media. Employees should immediately direct all media inquiries to the President and CEO. Please be polite when re-directing the press, as your conduct reflects on the organization.
7. Lending/Borrowing of Money/Property
  Staff, volunteers and students are not to lend or borrow money or property to/from program participants, as these activities may be seen as relinquishing control and/or giving payment for dubious reasons.
8. Modelling re: Substance Abuse Behaviours
  Staff, volunteers and students are to avoid behaviours/statements which could indicate a personal use of illegal substances or personal dependence upon alcohol and/or drugs in order to cope with life situations.
9. Counselling and Advice
  Staff, volunteers and students should provide youth with the appropriate resources to deal with issues and problems and avoid offering personal opinions (biases).
10. No Smoking (includes e-cigarettes)
  BGC Winnipeg is an organization that promotes healthy lifestyles for our members. Because of this philosophy and because Winnipeg municipal by-laws prohibit smoking in public places where children and youth under eighteen (18) years of age are permitted, there will be no smoking or act of smoking in any of the facilities housing clubs or BGC Winnipeg programs or within 30 meters of the property.
11. Sexuality Issues
  In ine with current agency policies, staff, volunteers and students are expected to demonstrate a high level of professional and personalmaturity, comfort and self-awareness in responding to issues of human sexuality.
12. Physical Contact
  Staff, volunteers and students are to avoid physical contact with program participants which may even be remotely construed as being excessive or having sexual contact, whether this contact be initiated by the staff, volunteers and students or the program participant. Staff, volunteers and students should avoid physical ‘horse-play’ with children as this may result in injury or allegation. This includes play-fights and tickling.
13. Language
  Staff, volunteers and students are to avoid using unprofessional language and name-calling while in their professional capacity, as this may be interpreted in a negative light and, thereby, affect the professional standing of the staff, volunteers and students and the program itself.
14. Dress
  Staff, volunteers and students shall maintain a constant awareness of their choice of dress and how it is, or may be, perceived by program participants and community members. See the Manual of Club Operations for a more detailed policy on appropriate dress.
15. Enforcing Rules
  Staff, volunteers and students shall make every effort to consistently enforce the rules of the club, so as to create an environment that is fair and where participants know what to expect.
16. Personal Life
  Staff, volunteers and students are to protect their own personal information from program participants and not share any contact information with members. This includes discussing personal matters of a sensitive nature in front of members, such as what happened on the weekend or life issues that staff, volunteers and students may be working through.
17. Consulting with Management
  If staff, volunteers and students are at all unsure as to the appropriateness of a specific behaviour, they should consult with their Club Manager, The Director of Programs, or the Director of Community Development.
I understand that BGC Winnipeg reserves the right to take disciplinary measures, which could include termination of employment/association, for breach of any of the above conditions.*

I acceptI decline
RELEASE FROM LIABILITY
Volunteers release BGC Winnipeg and its agents, representatives, trustees, officers, employees and volunteers from any liability arising out of any damage, loss or injury to the volunteer or his/her property incurred as the result of volunteer activities.*

I acceptI decline
AUTHORIZATION AND CONSENT
By checking this box, I agree that the information I have provided on the form is true and accurate. Furthermore, I understand and agree that submitting this application form does not automatically register my teenager as a youth volunteer. It is the policy of BGC Winnipeg to screen all prospective volunteers and students and we reserve the right to decline applicants who do not meet our requirements, needs and/or criteria. I understand that I will be advised in advance if other program specific checks may be required. While we try to place every volunteer/student; we do our best to place based on your skills, interests and availability with BGC Winnipeg requirements and needs at the time of application.*

I acceptI decline
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Next Steps:
• To complete the Online Volunteer-Student Orientation Training
• Review the Human Resource Manual
• To complete Accessibility Training

Thank you for your interest in supporting children in Winnipeg.
Should be Empty:

INDIVIDUAL YOUTH VOLUNTEER APPLICATION FORM

CONTACT INFORMATION

PERSONAL INFORMATION

EMAIL PREFERENCES

ADDITIONAL INFORMATION

EMPLOYER INFORMATION

VOLUNTEER EXPERIENCE

HOBBIES AND INTERESTS

AVAILABILITY FOR VOLUNTEER WORK

REFERENCES

EMERGENCY CONTACT

GUARDIAN CONSENT

MEDIA CONSENT

CONFIDENTIALITY POLICY

POLICY: DECLARATION OF STAFF, VOLUNTEER AND STUDENTS CONDUCT

RELEASE FROM LIABILITY

AUTHORIZATION AND CONSENT