Telecare Cambridge Distress Centre

Volunteer Application Form
 

PERSONAL INFORMATION
First Name
Family Name
Address
City
Province

Postal Code
Your Phone

Cell Phone
Your Email

 

AVAILABILITY 

Mornings    Afternoons   Evenings

 

POSITIONS OF INTEREST 

Distress Line      Board of Directors    Fundraising   Committees or Canvassing

 

COMMITMENT

Can you make a one-year commitment to this program?                          

Yes       No     

Can you commit to 4 hours a week with one shift a month on a Friday or Saturday or Sunday?  

Yes       No     

Can you complete the required training?           Yes       No     

 

OCCUPATION
Employer
Title/Position

Description of your position

Phone (e.g 905-555-5555)
May we phone you at work?                              Yes       No     

 

EDUCATION/TRAINING
High School Grade
College
University
Other

 

SKILLS
Do you speak languages other than English?               Yes       No     

If yes, please specify
Do you have a valid driver's license?                             Yes       No     
Do you have other skills or resources, which might benefit your work as a Telecare volunteer? (Hobbies, interests, training etc)

 

VOLUNTEER EXPERIENCE
Are you presently a volunteer?                                        Yes       No     
Have you had previous experience as a volunteer?       Yes       No     
Organization
Type of Work
Organization
Type of Work
Organization
Type of Work

 

HOW
How did you hear about Telecare Cambridge?

Volunteer Centres    Radio   Newspaper Road Sign

Current Volunteers        Website    Internet   Other  
Specify Where

 

MOTIVATION
Why, at this particular time in your life, have you chosen to volunteer with Telecare Cambridge? 
What are your expectations in volunteering with Telecare Cambridge?
What do you hope to gain from being a volunteer? 
What life experiences have you had that might be useful to you in working with the Telecare Cambridge volunteer program?
By submitting this application I hereby certify that all information included in this application form is true and complete. I understand that incomplete applications will not be considered, and that providing false information is grounds for immediate disqualification from the application process, or even immediate dismissal if the falsehood is discovered after hiring.
Date (dd/mm/yy)

 

REFERENCE CHECK
We would like to contact two references.  (1 Professional &/or Academic and 1 Personal)
Professional/Academic Reference
By submitting this application I hereby authorize Telecare Cambridge to solicit a professional/academic reference from:

Name       Phone #  

Title and relationship   

Personal Reference
Name      Phone #     

Title and relationship   

 
You will be required to sign a CONFIDENTIALITY AGREEMENT on acceptance of this application.

Note: Personal information on this form will be used to maintain volunteer records, to make placements and compile mailing lists for fundraising events and newsletters.  Questions regarding this collection of information can be forwarded to the Executive Director, Telecare Cambridge Distress Centre, Box 32074, Cambridge, ON N3H5C6. executivedirector@telecarecambridge.com