Town of Carbonear Volunteer Application Form

Participant Information

Please note: If under the age of 19, the form must be completed and signed by a parent or guardian

Question Title

* 1. Please complete the following:

Name

Address

Address 2

Town

Province

Postal Code

Email Address

Phone Number

Question Title

* 2. Date of birth:

Month/Day/Year

Date

Question Title

* 3. What is your availability?

Daytime

Evening

Weekends

Anytime with notice

Other (please specify)

Question Title

* 4. Can you provide a current valid copy of a Criminal Record and Vulnerable Sector Check?
Please note: If you do not have a current Criminal Record and Vulnerable Sector Check, please complete this application and submit it. We will provide a volunteer confirmation letter to waive the Code of Conduct fee.

Yes

Question Title

* 5. Do you have current First Aid/CPR Certificate:

CPR

Emergency First Aid

Standard First Aid

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* 6. Please provide 3 references

Reference #1 Name:

Position held

Relationship to participant:

Home #

Business #

Cell #

Email address:

Reference #2 Name:

Position Held

Relationship to participant

Home #

Business #

Cell #

Email address:

Reference # 3 Name

Position Held

Relationship to participant

Home #

Business #

Cell#

Email address:

Question Title

* 7. Declaration:
I acknowledge that everything declared in this form is true and I understand that if there is any change to the information contained in this application, it is my responsibility to notify the Town of Carbonear.

Parent/Guardian Signature: (If volunteer is under 19 years of age) Original copy of signed form must be submitted to the office.

Volunteer's Signature

Date:

Town of Carbonear Volunteer Application Form

Participant Information

Question Title

* 1. Please complete the following:

Question Title

* 2. Date of birth:

Question Title

* 3. What is your availability?

Question Title

Question Title

* 5. Do you have current First Aid/CPR Certificate:

Question Title

* 6. Please provide 3 references

Question Title

* 7. Declaration: I acknowledge that everything declared in this form is true and I understand that if there is any change to the information contained in this application, it is my responsibility to notify the Town of Carbonear.

* 7. Declaration:
I acknowledge that everything declared in this form is true and I understand that if there is any change to the information contained in this application, it is my responsibility to notify the Town of Carbonear.