Chigamik Volunteer Application

Thank you for your interest in volunteering at our Community Health Centre CHIGAMIK. Please print and fully complete the form below.  The information on this form will be kept confidential and will help us to find the most satisfying and appropriate participation/placement for you. If you require assistance in filling out this form, do not hesitate to let us know. 

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* 1. Please fill out your contact information below:

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* 2. Preferred method of contact

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* 3. I want to volunteer at CSC CHIGAMIK CHC because I like to......

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* 4. I would be available to volunteer..... (please indicate what days, time of day and number of hours you are available)

  Monday Tuesday Wednesday Thursday Friday Number of hours available
Mornings between 8am and 12pm
Afternoons between 1pm and 4pm

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* 5. Areas,programs and workshops of interest:  (Choose all that apply)

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* 6. Education level - Please indicate all levels of education you have completed, partial completion can be placed in "Other", ex High School - grade 11.

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* 7. Work or Volunteer Experience -  Please share any work experience, these can be paid work experiences, internships, volunteer experience, clubs, events you participated in that you feel may be relevant.

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