Volunteer Application

Personal Information

Surname

First Name

Second Name

Preferred Name

Address

Postal Code

Home Phone

Alternate Phone

Do you have any criminal convictions for which a pardon has not been granted?
(Note: Carewest requires all volunteers to complete a criminal records check)

YesNo

Why do you want to volunteer at Carewest?

Required for school;

number of hours required:

Personal growth and satisfaction

Other.

Please explain:

What hobbies and interests do you have?

Any additional information you would like to bring to our attention?

Volunteering Preferences

Available to work:

One Time

Weekly

Monthly

Would like to discuss in person

Shift Preference(s):

Morning

Afternoon

Evening

Flexible

What is your volunteer time commitment? (i.e. hrs/week):

Background Information

Have you previously volunteered at Carewest?

YesNo

Last Volunteer Year

Are you a current Carewest employee?

YesNo

Have you been previously employed at Carewest?

YesNo

Year of Termination

References

Enter at least one reference.

Reference Name	Title	Phone Number	E-mail Address

I hereby certify that the information and answers given by me in this application are true and complete in every respect and I understand that any false answers or statements made by me may be grounds for termination of employment. I also understand that if I am hired I will be required to provide personal information - including by birthdate, sex, S.I.N. Number, A.H.C.I.C. Number, emergency contact, marital status, names of spouse and dependents.

Carewest thanks all applicants for their interest. All volunteer applications are reviewed with consideration of current opportunities. Your application will be kept on file for 3 months.

The personal information on this form will only be collected and shared for purposes outlined in the Freedom of information and Protection of Privacy Act and Health Information Act which includes: determining eligibility for employment; determining eligibility for Carewest programs and services; for programs designed to evaluate and improve Carewest programs and services; for the operation of approved Carewest education and research programs and services; and for legal requirements where these purposes are consistent with the FOIPP and HIA Act and under the Alberta Labour Relations and Employment Standards Codes. If you have any questions regarding the collection of information you may contact the Carewest Manager of Information Management & Privacy, 722 - 16 Avenue NE, Calgary, AB T2E 6V7.

Volunteer Application

Personal Information

Why do you want to volunteer at Carewest?

Volunteering Preferences

Background Information

Where did you hear about Carewest?

References