VOLUNTEER SIGN UP FORM
Date		_________________
Full Name		_________________________________________________________
Address		_________________________________________________________
Postal Code		_________________		Phone Number		_________________________
Occupation
Education
How did you hear about us?
What do you hope to gain from volunteering?
What are your personal strengths, interests and hobbies?
What special interests or hobbies do you have that may be applied to a volunteer setting?
e.g.  music, arts, crafts, sewing, sports, etc...
Please list previous volunteer experience
Please list any areas of expertise, special training or certificates
e.g. sign language, CPR, First Aid
Please list three work or personal references that are familiar with your character and abilities
Name:
Relationship:					Phone:
Name:
Relationship:					Phone:
Name:
Relationship:					Phone:
Please indicate when you are available to volunteer
Mornings     Afternoons     Evenings     Days of the Week: ______________________
Please indicate the area(s) you wish to volunteer
Leisure Companion   Residential Assistance   Workshop Assistance   Community Events
Fund Raising             Administrative
Please leave this area blank
CPIC	__________		Orientation	_____________		Placement:
TB			Training			Date: