Volunteer Form

Are you over the age of 18?

Yes No

Are you willling to submit to a Criminal Record check?

Yes No

Have you ever volunteered with us before?

Yes No

Do you have access to a vehicle?

Yes No

Emergency Contact Info

Primary Contact Number

Alternate Contact Number

Background Information

Current or most recent employer

Full time or Part time?

May we contact you at work?

Yes No

Volunteer Experience

Weekday availability

Weekend availability

Have you ever done volunteer work before?

If 'Yes' above, please list your prior volunteer work.

Tell us about yourself, and why you are choosing HIV Edmonton for your volunteer activities

Do you have any special work-related skills, interest or hobbies that could be beneficial to our Society?

What do you hope to gain from this volunteer experience?

Reference Information

Reference Contact Information 1

Primary Contact Number

Alternate Contact Number

Reference Contact Information 2

Primary Contact Number

Alternate Contact Number

Authorization

In order to safeguard the clients which HIV Edmonton serves, I understand the need for HIV Edmonton to carefully screen all volunteer applicants. Information provided on volunteer applications and ascertained through Police Records Check & Vulnerable Positions Screening will only be used for the purpose of the volunteer’s position with HIV Edmonton, and will not be given to any other organization or outside party. I have completed andreviewed this entire form, and attest that the information I have provided is true. I understand any conditions that HIV Edmonton may impose in acceptance of a volunteer position with the Society and further understand that HIV Edmonton has the right to deny any individual as a volunteer of the Society.

Contact Information

Emergency Contact Info

Background Information

Volunteer Experience

Reference Information

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