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 Province Postal 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)

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

Is there any medical conditions you wish to share ?

Do you have any questions ?

Please note: There are forms that need to be filled at the centre we can mail them to you or you can pick them up at the centre.