Become a Volunteer

MaleFemale

IN CASE OF EMERGECY

EDUCATION & WORK EXPERIENCE

YesNo

AVAILABILITY

Please indicate what days suit your schedule for volunteering

MondayMorningAfternoonEvening

TuesdayMorningAfternoonEvening

WednesdayMorningAfternoonEvening

ThursdayMorningAfternoonEvening

FridayMorningAfternoonEvening

SaturdayMorningAfternoonEvening

SundayMorningAfternoonEvening

PREFERENCES

Is there a particular type of volunteer work in which you are interested?

YesNo

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

BACKGROUND VERIFICATION

Have you ever been convicted of a criminal offense

YesNo

Please list two non-family references whom we may contact
(i.e., personal, business, school or volunteer related)

REFERENCE ONE

REFERENCE TWO