HURON
MIDDLESEX
|
ABOUT
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SERVICES
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MEMBERSHIP
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FAQ
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VOLUNTEER
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FUNDING
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CONTACT
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Volunteer
Responsibilities
Qualifications
Application Form
Volunteer Application Form
Surname
First Name
Middle Name
Address
Apt #
City
Province
Postal Code
Home Phone #
Cell Phone #
Work Phone #
Email Address
Are you above the age of 18?
Yes
No
Do you have regualar access
to a reliable car?
Yes
No
Our volunteers must maintain $1,000,000 liability insurance on their vehicles.
Do you have adequate insurance?
Yes
No
Education
Highest level of education completed
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
OAC
College Year 1
College Year 2
College Year 3
College Year 4
University Year 1
University Year 2
University Year 3
University Year 4
University Year 5+
Area of Concentration
Other training which may be relevant (CPR, workshops, apprenticeship etc.)
Employment
Are you currently Employed?
Yes
No
Employer
Address
Occupation
Volunteer Experience
Present Experience
Past Experience
Other
Skills, Interests, Hobbies
Are you able to work with confidential information?
Yes
No
Would you object to a police check?
Yes
No
If yes, why?
Have you ever been convicted of a criminal
offence, which a pardon has not been granted?
Yes
No
Briefly state why you are interested in
becoming a volunteer with Victim Services
Is there any other information, which you
feel staff should be aware of?
References
Personal
Name
Address
Phone #
Occupation
Years Acquainted
Relationship
Professional
Name
Address
Phone #
Occupation
Years Acquainted
Relationship
Previous Volunteer Placement
Name
Address
Phone #
Occupation
Years Acquainted
Relationship
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