Step 1 of 3 33% Section A - Personal Information First Name* Last Name* Phone Number*Email* Address* City* Province*Select ProvinceAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonPostal Code* Current Occupation* Previous volunteer experience (organization and role)*Interests/Skills*Area of Volunteer InterestArea of Volunteer InterestJeneece PlaceQwalayu HouseChildren's Health Foundation EventsChildren's Health Foundation Administrative SupportChildren's Health Foundation General Help Section B - Availability & Additional InformationAvailability — Please check all that applyMorning Sunday Monday Tuesday Wednesday Thursday Friday Saturday Afternoon Sunday Monday Tuesday Wednesday Thursday Friday Saturday Evening Sunday Monday Tuesday Wednesday Thursday Friday Saturday How often would you like to volunteer?* Weekly Bi-weekly Monthly During special events Do you have any health concerns that may affect your volunteer work?* Do you speak any languages other than English?* Complete if volunteering to driveDriver’s License # Vehicle Options (check all that apply) Fits car seat Fits walker Wheelchair accessible Carries more than 4 passengers + 1 driver Section C - ReferencesReference 1 (Non-family)Name* Relationship to you* Phone Number*Reference 2 (Non-family)Name* Relationship to you* Phone Number*Emergency ContactName* Relationship to you* Phone Number*Have you ever had a criminal conviction for which you have not been pardoned?* Yes No I consent to a criminal record check. I also consent to a driver’s abstract if I have offered to drive. I recognize that participation as a volunteer cannot be guaranteed. I understand that my acceptance as a volunteer with Children’s Health Foundation of Vancouver Island (and Beacon Community Services, if volunteering at Jeneece Place) will be at the discretion of the staff of the organization. CONFIDENTIALITY: I will respect confidential information that I am given regarding the organizations and persons involved, including clients, volunteers, donors, staff and others. PRIVACY: Children’s Health Foundation and Beacon Community Services collect information from you for the purpose of providing volunteer services. The information collected is treated as confidential and is only disclosed for the above purpose. By click “I agree” below, you give consent to use the information as specified above.I have read and agree with these guidelines* I agree CAPTCHA Step 1 of 3 33% Section A - Personal Information First Name* Last Name* Phone Number*Email* Address* City* Province*Select ProvinceAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonPostal Code* Current Occupation* Previous volunteer experience (organization and role)*Interests/Skills*Area of Volunteer InterestArea of Volunteer InterestJeneece PlaceQwalayu HouseChildren's Health Foundation EventsChildren's Health Foundation Administrative SupportChildren's Health Foundation General Help Section B - Availability & Additional InformationAvailability — Please check all that applyMorning Sunday Monday Tuesday Wednesday Thursday Friday Saturday Afternoon Sunday Monday Tuesday Wednesday Thursday Friday Saturday Evening Sunday Monday Tuesday Wednesday Thursday Friday Saturday How often would you like to volunteer?* Weekly Bi-weekly Monthly During special events Do you have any health concerns that may affect your volunteer work?* Do you speak any languages other than English?* Complete if volunteering to driveDriver’s License # Vehicle Options (check all that apply) Fits car seat Fits walker Wheelchair accessible Carries more than 4 passengers + 1 driver Section C - ReferencesReference 1 (Non-family)Name* Relationship to you* Phone Number*Reference 2 (Non-family)Name* Relationship to you* Phone Number*Emergency ContactName* Relationship to you* Phone Number*Have you ever had a criminal conviction for which you have not been pardoned?* Yes No I consent to a criminal record check. I also consent to a driver’s abstract if I have offered to drive. I recognize that participation as a volunteer cannot be guaranteed. I understand that my acceptance as a volunteer with Children’s Health Foundation of Vancouver Island (and Beacon Community Services, if volunteering at Jeneece Place) will be at the discretion of the staff of the organization. CONFIDENTIALITY: I will respect confidential information that I am given regarding the organizations and persons involved, including clients, volunteers, donors, staff and others. PRIVACY: Children’s Health Foundation and Beacon Community Services collect information from you for the purpose of providing volunteer services. The information collected is treated as confidential and is only disclosed for the above purpose. By click “I agree” below, you give consent to use the information as specified above.I have read and agree with these guidelines* I agree CAPTCHA
