EDMONTON SENIORS CENTRE
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Volunteer Application Form
THANK YOU FOR THINKING OF US!
Personal Information
NOTE: All information on this form is confidential and is for office use only.
Fields marked with
*
are REQUIRED information and must be provided before submitting the form
.
*
Indicates required field
Name
*
First
Last
Birth Date (dd/mm/yy)
*
Street Address
*
City
*
Postal Code
*
Telephone # (please include Area Code)
*
Cell Phone # (include Area Code)
*
Email Address
*
Transportation
*
Car
Bus/Public Transport
Walk
DATS
Other
Will you require parking?
*
Yes
No
Do You Have Any Special Needs We Should Be Aware Of?
*
Yes
No
If YES, please specify...
*
SHIFT AVAILABILITY (please check all that apply):
Our office hours are Monday to Friday from 9 a.m. to 4 p.m.
Monday
*
AM
PM
Tuesday
*
AM
PM
Wednesday
*
AM
PM
Thursday
*
AM
PM
Friday
*
AM
PM
PREFERENCES:
Time of Day
*
Mornings
Afternoons
Frequency
*
Regular Shifts
Occasional Shifts
Summer or School Term (define in Comments)
Comments / Skills / Interests/ Length of Time Available
*
Emergency Contact (in Edmonton):
Name
*
Telephone #
*
Relationship
*
VOLUNTEER OPPORTUNITIES
(please check any & all areas of interest)
:
[object Object]
*
Back Office Assistant
Thrift Shop (10-3)
Nevada Desk
Crafter (in Home)
Crafter (at Centre)
Computer Skills Helper
Choose Any
*
Special Events/ Set Up/ Clean Up/ Tickets
Entertainment/ Musical/ Comedy
Services / Clinics (if yes, provide details below)
Instructor (if yes, provide details below)
General around the Centre :)
Choose Any
*
Lead Groups/ Readers/ Cooking/Walk
Hot Lunch (Set-Up/Serve/Clean)
Bingo Caller / Cashier
Casino (every 2 years)
Other (please provide details below)
Outreach is Long Term & Req. Refs & Police Check
Provide details for services/clinics, instructor or other here:
*
Submit
✕