MaleFemale
Double DosedSingle DosedNot Vaccinated
YesNo
Please indicate what days suit your schedule for volunteering
MondayMorningAfternoonEvening
TuesdayMorningAfternoonEvening
WednesdayMorningAfternoonEvening
ThursdayMorningAfternoonEvening
FridayMorningAfternoonEvening
SaturdayMorningAfternoonEvening
SundayMorningAfternoonEvening
Is there a particular type of volunteer work in which you are interested?
Please check all that apply Boutique Cashier, Sorter, Display- 12:15 - 3:45pmVisiting one-to-one with residentsClerical Support (phoning, sorting, stuffing envelopes)Nail CareMusic HelperDementia Care AssistantExercise / Rehab HelperSunday Church Helper - 2:30-4:00pmFront Door Greeter - WeekendsBingo & Games BuddyGardeningChurch HelperHappy HourEntertainerMedical & Shopping EscortOther
Have you ever been convicted of a criminal offense
Please list two non-family references whom we may contact (i.e., personal, business, school or volunteer related)
Please leave this field empty.