Volunteer Application Form
Rendez-Vous Champlain Volunteer Application Information on you! Name, Age Street Address City, Postal Code Home Phone Work Phone E-Mail Address Spoken Languages ___ English ___ Français Availability During which hours are you available for volunteer assignments? ___ Friday morning ___ Saturday morning ___ Sunday morning ___ Friday afternoon ___ Saturday afternoon ___ Sunday afternoon ___ Friday evening ___ Saturday evening ___ Sunday evening ___ Friday night ___ Saturday night ___ Sunday night Morning (8:00 am – 1:00 pm) | Afternoon (12:00 pm – 5:00 pm) | Evening (4:00 pm – 9:00 pm) | Night (8:00 pm – end) Interests Tell us in which areas you are interested in volunteering ___ Administration ___ Talent\Band Assistance ___ Promotion ___ Lighting and Sound Assistance ___ Field Work ___ Souvenir Sales ___ Visitor Surveying ___ Ticketing ___ Parking \ Barricades ___ On-Site Information ___ Site Prep ___ Driver Volunteer Hour Reporting Do you require a summary report of volunteer hours? ___ No ___ Yes, for completion of high school hours ___ Yes, for other reason Special Skills or Qualifications Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports. 10 Robert St W, PO Box 5009, Penetanguishene, ON, L9M 2G2 | (705) 549-7453 | champlain@penetanguishene.ca Certification Check any currently valid certification you have. ___ Standard First Aid ___ Lifeguarding / Bronze Cross ___ Standard First Aid Level ‘C’ with CPR/AED ___ WHMIS ___ Accessible Customer Service Standards Training ___ Other If other, please specify: _____________________________________________________________ Previous Volunteer Experience Summarize your previous volunteer experience. Person to Notify in Case of Emergency Name Street Address City, Postal Code Home Phone Work Phone E-Mail Address Do you have any medical conditions? (specify) Agreement and Signature By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. Name (printed) Signature Date Our Policy It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Information collected will be handled in accordance to the Town of Penetanguishene’s By-Laws and policies, and may be subject to the Freedom of information act, where applicable. Thank you for completing this application form and for your interest in volunteering with for the 2015 Rendez-Vous Champlain Festival. 10 Robert St W, PO Box 5009, Penetanguishene, ON, L9M 2G2 | (705) 549-7453 | champlain@penetanguishene.ca
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