MemoraCare Technologies Volunteer Application

Volunteer Application Form

Thank you for your interest in Volunteering at MemoraCare Technologies. Volunteers are an important part of our product trials for Remember MEdia, and the future of our business model. In order to be considered for our Volunteer team, you will need to sign an offence declaration form and apply for an up to date Vulnerable Sector Police Check. We also require Volunteers to sign policy agreements for "Zero Tolerance of Abuse and Neglect" and "Confidentiality" to protect the people and families we serve. Volunteers must be 18+ to apply. Once you apply, we will contact you to arrange an in person meeting to complete the orientation process. If you have any questions, please email jessica@remembermedia.org.
Niagara Regional Police, Vulnerable Sector Checks Information

Fillable Form: https://www.niagarapolice.ca/en/what-we-do/resources/1---PRC-Application-Form---fillable-form.pdf

Online Application: https://www.policesolutions.ca/checks/services/niagara/
If you have an up to date VSC within the last 6 months, please upload it here.

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Full Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Phone Number
Emergency Contact Name:

First NameLast Name
Emergency Contact #
How did you hear about us?
Please Summarize why you would like to Volunteer with us, and any skills/experience that make you a good fit.
Available Start Date

MonthDayYear
Preferred assignment locations:

WellandNiagara FallsGrimsbyBeamsville/VinelandSt. CatharinesPort ColborneFort ErieRidgeway/Crystal BeachOther
Other (Please specify):
Availability:

Weekday MorningWeekday AfternoonWeekday EveningWeekend MorningWeekend AfternoonWeekend Evening
Please specify if you have a specific day/time:
Reason(s) for Volunteering:

Personal SatisfactionGive Back to the CommunityHelp PeopleKeep BusyShare My SkillsEducation RequirementGain ExperienceSocial Connection
Can you please provide us with a head shot of yourself for you name tag? If you do not want to do this right now, we can complete this at orientation.
Additional Comments:
Should be Empty:

Volunteer Application Form