Volunteer Form

PHSS Volunteer Application Form

Age Range (applicants under the age of 18 must have a parent/guardian contact PHSS and complete a signed hardcopy application - with a parent or guardian's signature.) If you are under the age of 18, this form will not be submitable.

I am over the age of 18

I am under the age of 18

First name

Last name

Email

Phone

Address

Preferred method of contact

Email

Phone Call

Text

Do you have an previous experience(s) that you think may be applicable?

If able, please upload your resume

Period of Commitment

3-6 Months

6 Months - 1 Year

Ongoing

How did you hear about volunteer options at PHSS?

Do you have a current vulnerable sector police check?

Yes

No

Acknowledgement & Authorization

I agree to the following acknowledgement and authorization

Any information received during my volunteer period concerning the personal, financial or other private affairs of the Persons Supported by PHSS will be treated by me in strict confidence and will not be divulged. I also understand that the information that I have provided in this Application to Volunteer will be verified by PHSS. I hereby grant permission to PHSS to contact any persons who might be able to verify the information. The confidential information on this form is collected under the Health Protection and Promotion Act, R.S.O. 1990, c.H.7 and will be maintained on file. This information will be used for volunteer program planning purposes. If you require further information about this collection contact PHSS.

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