Volunteer Application

APPLICATION TO VOLUNTEER
Name:

Address (include mailing):

Telephone no: Drivers License #
Place of birth (necessary for criminal record check):
Date of birth:
Which of the following programs are you interested in volunteering?
Meals on Wheels DeliveriesBetter at Home
Do you have a valid BC Driver’s License? YesNo
Do you have your own transportation? YesNo
Do you have valid car insurance? YesNo
Rate class:
Do you have a current first aid certificate? YesNo
Expiry date:
Languages spoken other than English
Have you previously volunteered with this agency and if so, when?

Please list any special skills, experiences or qualifications which you feel would especially prepare you for volunteering with this agency:

Are there any days during the week that you are not available to volunteer? If so, please list.

REFERENCES
Because our organization serves the disabled and elderly population of the community, we are required to conduct reference checks on all employees and volunteers.

Please provide 3 references. (Preferably 1 employment and 2 volunteer reference)

1.Company’s name & address
Supervisor’s name and telephone no.
Employed from
to
Position/Duties

2.Character Reference Name
Contact Phone Number
Nature Of Relationship

3.Character Reference Name
Contact Phone Number
Nature Of Relationship

Following a successful interview, and prior to commencing employment or volunteering, applicants must complete a Criminal Record Search, done in our office.

This application is considered a legal document and any false information will forfeit any claims to employment. By signing this form you acknowledge that Princeton & District Community Services Society has the right to check the validity of this application.

Signature:
Print Name:

Date: Position applied for