Volunteer Intake Form
We recognize that there are many questions to answer and that this form may take some time to complete. We thank you for your patience and ask you to be as honest as possible with the information you provide. The folks who access Thrive HIV Prevention + Support services are vulnerable in many intersecting ways. It is important that we have a full understanding of what brings you to our organization. Please let us know if you have any questions or concerns from filling out this form. Thanks!
Which of our office locations are you interested in volunteering with?
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Kitchener - 5-1770 King Street East, Kitchener, N2G 2P1
Cambridge - 163-150 Main Street, Cambridge, N1R 6P9
Guelph - 105-77 Westmount Road, Guelph, N1H 5J1
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Your Details!
Please fill in the below information so we know how to get in contact with you!
Name:
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First Name
Last Name
Pronouns:
Address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number:
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Please enter a valid phone number.
Format: (000) 000-0000.
Email:
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example@example.com
Preferred method of contact:
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Phone Call
Text Message
Email
Do you need discretion when being contacted:
Yes, I need discretion when calling me, leaving a voicemail, and/or text message
Yes, I need discretion when sending an email
Note: This is only for legal purposes. If you are under the age of 14, you are required to fill the Youth Volunteer Consent Form BEFORE starting your volunteer work with THRIVE.
Are you under the age of 14?
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Yes
No
Emergency Contact Name
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First Name
Last Name
Emergency Contact Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
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Tell us a bit about yourself!
How did you hear about Thrive HIV Prevention + Support?
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Do you have any personal, professional, or academic experience related to HIV, STBBI Prevention, or substance use?
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What is your current occupation or recent work?
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If you have previous volunteer experience, please describe:
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What do you consider the toughest aspect of volunteering?
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What do you hope to gain from volunteering with us?
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What hobbies, interests, or skills can you bring to a volunteer position?
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How do you feel about volunteering with people that have different lived experiences than your own?
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Do you speak and/or write in any language other than English? If yes, which languages?
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How do you get around town?
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I have a valid driver's license
I have access to a vehicle
I use public transit
Additional Information to note:
A select few volunteer positions with THRIVE involve sensitive information, which may require a police vulnerable sector check. If this is required, the Manager of Volunteers will inform you prior to beginning that specific volunteer role.
For any volunteer position involving the operation of a motor vehicle, the volunteer must also fill out our Driver Waiver Form and submit proof of insurance. Further details regarding the forms needed before becoming a driver for THRIVE will be provided by the supervisor of that role.
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Availability
Please note: Volunteer roles are primarily during office hours. There are some events that happen on evenings or weekends, but they are seasonal and very limited.
How long are you willing to be a volunteer with us?
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How often are you wanting to volunteer with us?
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Weekly
Bi-Weekly
Monthly
Seasonally
Other
Tell us when you would be available during the week:
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Rows
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Morning
Afternoon
Evening
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References:
THRIVE requires a screening of all volunteers, in order to maintain the confidence of the communities we serve. Please supply us with the names and contact information of two professional references you have known for one year or more, that we may contact. You may let them know we will either call them or send an email with a form to complete and return to THRIVE. The volunteer application process will not be completed without the return of at least one reference.
Reference 1:
Name
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First Name
Last Name
Their relation to you:
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Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Reference 2:
Name
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First Name
Last Name
Their relation to you:
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Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Release Form
All information supplied in this application is treated confidentially and will only be used for the processing of new volunteers. I understand that I am under no obligation to work as a volunteer for THRIVE and that THRIVE is under no obligation to accept my services. However, should my application be approved, I agree to serve as a volunteer for Thrive HIV Prevention + Support, and commit to the following:
I commit:
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To perform my Volunteer duties to the best of my abilities
To adhere to Agency rules and procedures, including record-keeping requirements and Confidentiality of Agency and Participant information
To meet time and duty commitments, or to provide adequate notice so that alternate arrangements can be made
Signature
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Date
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Month
-
Day
Year
Date
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Philosophy Statement
Thrive HIV Prevention + Support serves the community as a source of reliable, evidence-informed, and current information on all aspects of HIV, Hepatitis C, sexually transmitted and blood-borne infections (STBBIs), sexual health, and harm reduction. Thrive HIV Prevention + Support is a voice for people living with HIV, Hepatitis C, and other STBBIs, as well as individuals and communities impacted by substance use and related stigma. Thrive HIV Prevention + Support believes in the promotion of safer sex and safer substance use practices, including condom distribution and access to harm reduction supplies and education. Thrive HIV Prevention + Support is committed to reducing stigma, discrimination, and systemic barriers related to HIV, STBBIs, Hepatitis C, substance use, sexuality, gender identity, race, religion, age, sex, disability, housing status, or socioeconomic status. Thrive HIV Prevention + Support does not discriminate on the basis of sexual orientation, gender identity or expression, race, religion, age, sex, HIV or Hepatitis C status, substance use, or any other protected ground under human rights legislation.
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I have read the Release Form and Philosophy Statement
I agree to abide to these principles while volunteering with THRIVE
I agree to read THRIVE's policy on Confidentiality and adhere to the rems and conditions set within
I grant permission for THRIVE's Manager of Volunteers and/or Volunteer Coordinator to contact the references I gave in this application
Name
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First Name
Last Name
Signature
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Date
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-
Month
-
Day
Year
Date
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