Become a Volunteer - North Simcoe Victim Services

PART A: IDENTIFICATION

Name *

First

Last

Preferred Gender Pronouns

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Landline Residence Phone #

Cellphone #

Email *

Are you 21 years of age or older?

Spoken Languages

How did you hear about North Simcoe Victim Services (NSVS)?

Tell us about yourself:

PART B: EMPLOYMENT AND EDUCATION

List and Explain any Community Involvement and Volunteer Experience (extent of experience, skills acquired, impressions of work experience):

PART C: EMPLOYMENT AND EDUCATION

Please indicate your current status *

Employed
Retired
Student
Other

If you selected 'other' - please explain

Employment (present position, related work experience):

Education/Training (include any volunteer training, workshops, etc.)

PART D: GENERAL INFORMATION

Are you currently volunteering for another organization?

Do you give NSVS permission to use written comments and/or your personal photos for the purpose of distributing newsletter and promoting the program on social media?

Signature

Clear Signature

NSVS is a 24-hour, 7-day a week service. Can you realistically commit to the program for at least one year?

Do you drive?

Do you have the use of a reliable vehicle?

Driver's License Number

PART F: REFERENCES

Professional Reference:

Name of Professional Reference:

Relationship to Volunteer Applicant:

Telephone Number:

Volunteer Reference

Name of Organization:

Name of Volunteer Supervisor:

Telephone Number:

Personal Reference

Name:

Relationship to Volunteer Applicant:

Telephone Number:

DECLARATION

In making this application, I give North Simcoe Victim Services permission to contact those persons named as my references after completion of an interview, in order to ascertain my suitability as a crisis response volunteer. In addition, I agree to provide to NSVS a copy of my Canadian Police Information Centre Check and Vulnerable Sector Screening. I hereby certify that all information included in this application form is true and complete.

Signature

Clear Signature

Date / Time

Date

Time

Volunteer with NSVS

Volunteer Application

PART A: IDENTIFICATION

PART B: EMPLOYMENT AND EDUCATION

PART C: EMPLOYMENT AND EDUCATION

PART D: GENERAL INFORMATION

PART F: REFERENCES

Professional Reference:

Volunteer Reference

Personal Reference

DECLARATION