This application is designed with the safety of our members, volunteers, clients, and organizations in mind. Dependant on the position applied for, various screening methods may be conducted (this may include police record and/or child welfare checks). Application for a postion does not guarantee acceptance.

Name:     Date:

Address:

Phone:     Email:

Age: over 18?     Yes     No     If no, how old are you?

Emergency Contact:

Emergency Contact Phone:

Have you ever volunteered for V-VAC before?     Yes     No

Transportation:     Vehicle     Taxi     Bike
Other (walk, etc.)

Employment Status:     Full time     Part time     Student

Position Applying for:

How did you hear about it?     Newspaper     Phone     Website

Why are you interested?     Work experience     Personal Satisfaction

Availability:     Monday     Tuesday     Wednesday

Time(s)Available:
Term length:     +6 months     -6 months     Special Events

Special Skills/Interests/Qualifications:
(certificates/tickets, computer skills, board experience, etc.)

Are there any client groups or types of work you don't want to be involved with?     Yes     No
If yes, please list and explain:


Areas of interest: (check all that apply)

Animals Arts & Crafts Bingos Boards/Committees Children Community events Computers Cooking/Kitchen work Crisis/Help line Direct service (reading, shopping) Drivers Entertainment Environment Fine Arts Friendly Visitor Gardening Food/Hamper prep Other:

Health Care Health/Exercise Immigration Mentoring Museum/Culture Office Palliative care Recreation/Sports Schools Seniors services/Care Service Clubs Special Needs Special Projects Youth Programs Tutoring Victim Services Virtual Volunteering Writing/Journalism

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