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Volunteer Application Form

Apply Online
 
Following the completion of this form, please proceed to Step 2 of the application process and complete the Reference Form.


Personal Information
Salutation:
Full Name:
Common Name:
Home Phone:
Work Phone:
Cell / Pager:
Best time to call:
Apt. / Unit:
Street Address:
City:
Province:
Postal Code:
Nearest Main Intersection:
E-mail Address:
Date of Birth
(dd/mm/yyyy):
 
Sex:
If any, please describe any physical or mental health conditions or other restrictions that could affect the kind of volunteer work you do:
If you have ever been convicted of a criminal offense for which you have not been pardoned, specify:
How did you hear of this opportunity to volunteer?

Emergency Contact Information

Name:
Relationship:
Phone Number: 1
2

Skills and Experience

Volunteer/Work Experience:
Special Skills:
Professional:
Education:

Languages

SpeakWrite
Preferred Language:

Availability

Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Morning
Afternoon
Evening

Volunteer Placements
Please indicate the volunteer assignments or activities that interest you most:

1.
2.
3.


Agreement

  • I understand that volunteering is a responsibility and I will fulfill the requirements and time commitments of my assignment(s) to the best of my ability.
  • I understand that I will be required to satisfactorily serve a probationary period.
  • I hereby authorize Bridgepoint Hospital to obtain references from any of my referrals in connection with my application for a volunteer placement.

Checking this box is the equivalent of a signature on this form, and implies that you agree to, and understand, the above document. You also agree that all the information above is correct.
Date:


 
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