VOLUNTEER APPLICATION
 

First Name:

Last Name:

Address:

City:

Province:

Postal Code:

  Telephone:

E-Mail:

Check the days & times which you will be available for volunteer work:
Monday From: To:
Tuesday From: To:
Wednesday From: To:
Thursday From: To:
Friday From: To:
Saturday From: To:
Sunday From: To:

What are your interests? (Check all that apply)
Sports  (Please Specify):
Music     Gardening    Photography
Art       (Please Specify):
Cinema   Theater        Philosophy
Literature    Other  (Please specify):

Why Do You Want To Volunteer With Dixie Bloor?
I Want To Help Others       To Gain New Experience        
Requirement for School      To Gain Experience In Order To Find A Job
Other Reason(S):

What is your educational background?
Primary: Grade    Secondary: Grade
College: Course Name:
Graduated:Yes     No
University
Major:
Graduated: Yes    No
 
Are You Willing To Undergo Some Training Prior To Your Volunteer Work?
              Yes           No
 
How Did You Learn About Our Agency?
 
Friend          I Live In the Area Sign          Other Agency
DBNC Staff I Am A Member   I Am / Was A Program User
 
What Language(S) Do You Speak/Write?
Language(s) Spoken: 123
Language(s) Written: 123
 
The Following Services Are Currently Offered By This Agency.
Which Area Would You Be Interested In Being Involved With?
(Check All That Apply)

Child Care           Immigrant Settlement  Parent Network 
Family Drop-In    Multicultural Family Resource Seniors Programs
Toy Library         Youth (Must Be A Youth To Be Involved)
Language Instruction For Newcomers Office Administration
Special Events      Other:
 
Which Of The Following Areas Would Be Of Interest To You?
Children            Adults           Seniors Speaking To Groups 
Computer Work Office Work  Cleaning/Maintenance
Other:
 
Do You Have Previous Volunteer Experience? If Yes,
Then Please Specify The Organization And The Position, Which You Held.
1)
2)
 
What Are The Special Skills That You Would Like To Offer At This Agency?
 
Additional Comments:
 
I, the undersigned, understand that the Dixie Bloor Neighbourhood Centre,
its Board and staff will not be held liable for any injury, physical or otherwise,
I incur while volunteering for the agency.
 
 
       
                     Signature                                       Date
 
FOR OFFICIAL USE ONLY:

Close

Please mail or fax to:
Volunteer Coordinator
Dixie Bloor Neighbourhood Centre
1420 Burnhamthorpe Rd. East, Suite 315
Mississauga, Ontario, L4X 2Z9
(905) 629-1873

©2007 DBNC - Dixie Bloor Neighbourhood Centre