Family Advisors Application Form

Thank you for your interest in volunteering as a Family Advisor for Niagara Children’s Centre!

Please tell us a bit about yourself to help us match your skills, interests, experiences, and availability to a Family Advisor position. If you prefer, you can contact Holly Lismanis (FamilyEngagement@nigarachildrenscentre.com or 905-688-1890 ext. 202) to complete this application over the phone or in person.

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* 1. After reading the descriptions of the Family Advisor positions, I am interested in (check all that apply):

Being a member of the Family Advisory Network FAN [2 hour meetings at the Centre each month in the evenings September-June]

Being a member of a Centre committee [1-2 hours each month at the Centre in the daytime with additional time to pre-read materials] Examples of committee positions that may be available include the Diversity and Cultural Competence Committee and the Communications Committee

Being a member of a Project Team or Focus Group

Being a Virtual Advisor [flexible time commitment from home]

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* 2. Applicant Information

Name *

Street Address

City/Town

Home Phone

Cell Phone

Business Phone

Preferred contact method

Alternate contact method

Email Address

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* 3. I am a:

Parent/guardian

Foster parent

Grandparent

Sibling

Other family member or person who has made a commitment to care (please specify):

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* 4. My family is

Currently receiving services through the Niagara Children's Centre (including offsite satellite locations, School Based Rehabilitation Services, etc.)

Previously received services within the last 12 months