Community Connections Volunteer Form

Volunteer Driver & Friendly Visitor Application

This form is to apply to volunteer for the community connections program

Volunteer Driver & Friendly Visitor Application form

Your Name(Required)

First Last

DOB:(Required)

Phone(Required)

Your Address(Required)

Street Address Address Line 2 City ZIP Code

Your Email Address(Required)

Email Address Confirm Email Address

Emergency contact(Required)

First

Phone(Required)

Do you have any medical considerations or special needs we should know about?

What intrests you to volunteer with us?(Required)

Do you have and specialized Education or Training that will help you with this position?

Previous volunteer Experience? (please specify orginization and year)

What is your availability (can be changed later if needed)

Please provide 2 refrences that we can confirm your strengths and character:

Name(Required)

First

Phone(Required)

Relationship to reference(Required)

NAME(Required)

First

Phone(Required)

Relationship to reference(Required)

PLEASE SUBMIT THE FOLLOWING BY ATTACHING IT BELOW OR IN PERSON AT THE CENTRE

Completed Application

RCMP Security Letter including Vulnerable person

Signed Confidentiality Agreement

Signed Volunteer Waiver Form

Volunteer Declaration

File

Max. file size: 16 MB.

FOR DRIVERS ONLY Submit Below or Bring to the Centre

Proof of current Driver's License

Proof of Insurence(including 3ed party Liability) minimum $2 million

Proof of current vehicle Registration

Copy of drivers Abstract for 3 previos years

File

Max. file size: 16 MB.

File

Max. file size: 16 MB.

File

Max. file size: 16 MB.

File

Max. file size: 16 MB.

Are you able to safely lift a Walker or Wheelchair into your vehicle(Required)

Is there any medical conditions you wish to share ?

Vehicle: type/Make/Model/Year

Volunteer Driver & Friendly Visitor Application

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