Community Living Durham North

Board
For Employees

Volunteer Application

Download Volunteer Application Form or please fill out the following online form.

Contact information
Name(•):
Address:
City:
Postal Code:
Email (•):
Home Phone Number:
Business Phone Number:
Age Category:  14-16 17-19 20-30 31-54 over 55
We like to acknowledge our volunteers on their birthdays, during what month of the year may we send you a card?

Volunteer Experience
Organization:
Dates:
Duties:
Organization:
Dates:
Duties:

Hobbies & Interests (check all that apply)
 arts and crafts dancing, singing clerical sewing writing/literacy sports group leadership public relations public speaking organizing events swimming woodworking child care driving bowling
Other:

Transportation
Driver's License?  Yes No
Class of License:
Are you willing to use your car during your activities as a volunteer?

 Yes No

Additional Information
How did you hear about our Association's Volunteer Program?
Why are you interested in becoming a volunteer with Community Living?
With whom would you prefer to volunteer? (check all that apply)
 Adult Male Adult Female Program Special Events
When would you be available to volunteer? (check all that apply)
 Day Evening Weekday Weekend Year Round Summer Only
How often are you available to volunteer?
 Once a week Every other week Once a month
Other:

References
Name:
Mailing Address:
Duties:
Telephone:
Relationship:
Name:
Mailing Address:
Duties:
Telephone:
Relationship:
I hereby declare that the foregoing information is true and complete to my knowledge. I, hereby authorize the Volunteer Coordinator/Program Director to contact the references listed on this application.
I Accept

Community Living Durham North

Charitable Registration #: 106887813 RR001

P.O. Box 964 Port Perry ON L9L 1A8 T:905-985-8511 F:905-985-0799

United Way