Volunteer Application

First Name (required)

Last Name (required)

Home Address (required)

City (required)

Postal Code (required)

County (required)
 Bruce Grey Perth

How long have you been a resident of this area (in years) (required)

Home Number (required)

Work Number

Cell Number (required)

Email (required)

Emergency Contact Name (required)

Relationship to you (required)

Emergency Contact Number (required)

Do you have a valid driver's license (required)
 Yes No

Do you own, or have access to, a vehicle that you can use for Victim Services (required)
 Yes No

Highest level of education attained (required)
 High School Post-Secondary

Please list any relevant courses or training

Are you currently employed (required)
 Yes No

Employer

Type of employment

Position

Please list your previous Volunteer Experience(s)

Please check any other volunteer opportunities you would be interested in with Victim Services (check all that apply)
 Host a booth at a fair or workshop Attend Open Municipal Council Meetings in your area Social Media New Volunteer Training Office Work Graphic Design Website Management IT

Have you applied to Victim Services in the past (required)
 Yes No

In order to effectively serve the needs of our communities, our volunteers make a year-long commitment during which they are on call for 12 hours per week or 48 hours per month. Do you foresee any situation that would prevent you from keeping this commitment? (required)
 Yes No

What volunteer shifts would you prefer (check all that apply)
 Days Evenings Weekend

How did you become aware of Victim Services volunteer opportunities? (check all that apply)
 Facebook Ad Newspaper Ad Digital Ad Family/Friend Work or School Community Event Emergency Services

Describe

References: Please note that prior to acceptance into our training program, we require 3 references-1 personal and 2 professional references.

I hereby declare that the above information is true and complete to the best of my knowledge. I understand that a false statement may disqualify me from further consideration as a volunteer or result in dismissal.

Signature (required)
 Yes No