Rural VISIONS Centre

Volunteers In Service In Our Neighbourhoods

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Volunteer Registration

CFCSC Volunteer and Service Provider Registration

This personal information is collected for coordination, recognition and statistical information only. Safeguards are in place to protect this information, accessible only by Staff and Administrative Volunteers at Rural VISIONS Centre, Sydenham. By submitting this form, you are providing us with consent to use this information to place you in volunteer positions. After receiving this form, we will request an interview at the Rural VISIONS Centre as well as a police background check.

Contact Information

First Name:

Last Name:

E-mail:

Phone Number:

Address:

Occupation:

Employer:

Desired Volunteer Position(s):

Can you drive?
Yes No

Part Two

Related Training/Experience:
Skills, Interests, Hobbies:
Past or present Volunteer jobs:
Don't ask me to:

Volunteer Time Available:

Days:

Evenings:

Weekends:

How Often?

Present Health:

Language Spoken:

Languages Written:

Will you drive for clients or agency?
Yes No

References:

Name:

Address:

Telephone:

Name:

Address:

Telephone:

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