Volunteer Application Form

This application must be completed by anyone wishing to volunteer with the North End Family Centre. In order for the North End Family Centre to provide a secure environment for all people, the following questions must be answered honestly and completely.

All information will be kept strictly confidential. Any questions of a sensitive or personal nature may be discussed with staff upon completion and may not necessarily exclude your involvement with the North End Family Centre.

Personal Background:

Name:

Address:

Home Telephone:

Alternate Telephone:

Email Address

Health and Emergency Information:

Emergency Contact:

Name:

Relationship:

Phone Number:

Alternate Phone Number:

Health Concerns:

Please list known allergies, illnesses, medical concerns or conditions that may impact your volunteering with the North End Family Centre:

What areas are you interested in volunteering?

Do you have previous experience working with this type of ministry/organization? If so, please provide the name of the organization you worked under, time frame and responsibilities:

Confidential Information:

We feel that in order to provide a safe environment for all people of all ages, it is necessary to include the following questions as part of the application process. All information will be kept in strict confidence. Answering yes to any of the following questions does not necessarily disallow your involvement with the North End Family Centre.

Do you have a criminal record or have you ever been convicted of a criminal offence? If yes, please explain:

Have you ever used or sold drugs? If yes, please explain:

Have you ever been accused, arrested or convicted for any abuse related crimes? If yes, please explain:

Have you ever been accused, arrested or convicted for any sexually related crimes? If yes, please explain:

Are there any circumstances involving your lifestyle or background that would call into question your ability to work with minors? If yes, please explain:

References:

Please provide the name of three individuals, excluding relatives, who could provide a reference for you.

1. Name:

Address:

Phone Number:

Email:

2. Name:

Address:

Phone Number:

Email:

3. Name:

Address:

Phone Number:

Email:

Release of Information:

I give the North End Family Centre permission to contact the people I have listed as references to determine my suitability for volunteering with the North End Family Centre.

I give the North End Family Centre permission to perform a personal criminal records check, for purposes of my protection against any false allegations and for the protection of those I serve. I consent to the records check with the understanding that the results will be kept confidential.

The information contained in this application is correct to the best of my knowledge.

Should my application be accepted, I agree to work within the North End Family Centre's Constitution, Statement of Faith, Policies, and Procedures.

Applicant's Signature:

Date:

Thank you for filling out this application form. We sincerely appreciated your willingness to serve and we look forward to you joining our team.

Our Program Coordinator will be in touch with you within a few days.

Volunteer Application Form

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