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Volunteer Form
"
*
" indicates required fields
Name
*
First Name
Last Name
Address
*
Street Address
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Telephone
*
Email
*
Please indicate the volunteer program you are interested in.
Programs
Vaccination clinic
Badminton club
Card/knitting/sandbag clubs
Walking club
Community gardens
Exercise program
Green box program (fruit and vegetable distribution)
Office work
Other:
Other
When could you start volunteering?
In what field do you have work experience?
Are you willing to provide proof of no criminal record?
*
Yes
No
This proof must be dated within the last 6 months. This document is a requirement of the CSCE’s funding agency.
Are you available on a regular basis?
Yes
No
Please specify
When are you available?
Monday
Morning
Afternoon
Evening (after 4:30 p.m.)
Tuesday
Morning
Afternoon
Evening (after 4:30 p.m.)
Wednesday
Morning
Afternoon
Evening (after 4:30 p.m.)
Thursday
Avant-midi
Après-midi
Soir (après 16h30)
Friday
Morning
Afternoon
Evening (after 4:30 p.m.)
Saturday
Morning
Afternoon
Evening (after 4:30 p.m.)
Sunday
Morning
Afternoon
Evening (after 4:30 p.m.)
Please provide the names of one reference, if possible, at least one employer:
Name
*
First Name
Last Name
Telephone
*
Email
*
Link
Please provide the name to contact in case of emergency:
Name
First
Last
Telephone
*
The CSCE aims to provide access to healthcare for the French-speaking population of Eastern Ontario. As a result, the working language at the CSCE is French.
Are you willing to work primarily in French?
*
Yes
No
