Volunteer Application

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Personal Information > Employment History > Education/Training > Abilities/Skills > Volunteer Experience > Interests > Screening > Commitment

Personal Information

First name(Required)

Last name(Required)

Address(Required)

Street Address City ZIP / Postal Code

Home phone

Cell phone(Required)

Email address(Required)

Date of birth(Required)

MM slash DD slash YYYY

Emergency health information(Required)

Is there any information a health care professional should know should you suddenly become ill? i.e., allergies, medical conditions, contact lenses, etc. Please put N/A if it is not applicable to you.

Emergency contact name(Required)

Emergency contact phone(Required)

Relationship to applicant(Required)

Personal Information > Employment History > Education/Training > Abilities/Skills > Volunteer Experience > Interests > Screening > Commitment

Employment History

Are you currently employed?(Required)

Yes

Current employer(Required)

Current work schedule(Required)

Full time

Part time

Casual

May we contact you at work?(Required)

Yes

Phone(Required)

What previous jobs have you had?(Required)

Please put N/A if it is not applicable to you.

Personal Information > Employment History > Education/Training > Abilities/Skills > Volunteer Experience > Interests > Screening > Commitment

Education/Training

Are you currently a student?(Required)

Yes

Current school/university(Required)

Area of study and/or grade level(Required)

Please list any skills from either present or past employment/education which will contribute to your success as a volunteer.(Required)

Have you any specific Hospital or Health Care training?(Required)

Yes

Please describe your hospital or health care training(Required)

Personal Information > Employment History > Education/Training > Abilities/Skills > Volunteer Experience > Interests > Screening > Commitment

Abilities/Skills

Please describe your personal talents, hobbies, interests and special skills.(Required)

Do you speak or write languages other than English? Please specify.(Required)

Personal Information > Employment History > Education/Training > Abilities/Skills > Volunteer Experience > Interests > Screening > Commitment

Volunteer Experience

Are you currently a volunteer?(Required)

Yes

Where are you currently volunteering?(Required)

Please describe any previous volunteer experience(Required)

Please put N/A if it is not applicable to you.

How many hours per week are you willing to volunteer?(Required)

Minimum two (2) hours per week.

What days and times are you available? Select all applicable.(Required)

Monday morning

Monday afternoon

Monday evening

Tuesday morning

Tuesday afternoon

Tuesday evening

Wednesday morning

Wednesday afternoon

Wednesday evening

Thursday morning

Thursday afternoon

Thursday evening

Friday morning

Friday afternoon

Friday evening

Saturday morning

Saturday afternoon

Saturday evening

Sunday morning

Sunday afternoon

Sunday evening

Personal Information > Employment History > Education/Training > Abilities/Skills > Volunteer Experience > Interests > Screening > Commitment

Interests

Why are you interested in volunteering at St. Michael’s Care Centre?(Required)

What type of volunteering opportunities are you looking for?(Required)

Are you interested in assisting with Special Events?(Required)

Yes

Personal Information > Employment History > Education/Training > Abilities/Skills > Volunteer Experience > Interests > Screening > Commitment

Screening

If requested, are you willing to submit to a criminal records check?(Required)

Yes

Please provide us with two references (professional or volunteer related reference, not from someone related to you or a personal friend).

REFERENCE 1

Name(Required)

Relationship to you(Required)

Phone(Required)

Email address(Required)

REFERENCE 2

Name(Required)

Relationship to you(Required)

Phone(Required)

Email address(Required)

Personal Information > Employment History > Education/Training > Abilities/Skills > Volunteer Experience > Interests > Screening > Commitment

Commitment

I confirm that the information in this volunteer application is complete and true.(Required)

I confirm that the information in this volunteer application is complete and true.

I authorize St. Michael’s Centre to contact the references listed and give permission to these references to release all relevant information requested(Required)

I authorize St. Michael’s Centre to contact the references listed and give permission to these references to release all relevant information requested

I agree to attend a mandatory Orientation for Volunteers & to complete the required training.(Required)

I agree to attend a mandatory Orientation for Volunteers & to complete the required training.

I agree to respect the confidential nature of the volunteer role, and I understand that breach of confidentiality is cause for dismissal from volunteer service.(Required)

I agree to respect the confidential nature of the volunteer role, and I understand that breach of confidentiality is cause for dismissal from volunteer service.

I agree to abide by the Centre’s policies, rules, and regulations.(Required)

I agree to abide by the Centre’s policies, rules, and regulations.

I give permission for the Dept. of Volunteer Services to keep my personal information on site in both paper and electronic format. I understand that this information will only be disclosed to staff who need this information to contact me regarding matters relating to my volunteer work.(Required)