Volunteer Application

About You

Fields marked (*) are required.

• Name*
• Address*
• Address 2
• City*
• Province*
• Postal Code*
• Email*
• Home Phone*
• Work Phone
• Cell Phone
• May we call you at work?*
  Yes No
• I have read the Frequently Asked Questions about volunteering on the Distress Line*
  Yes No
• Are you 18 or older?*
  Yes No
• I realize that Distress Line training is mandatory and have checked out the currently posted training dates. I am interested in attending the following session*
• How did you learn about our volunteer opportunities?*
  Newspaper Poster / Billboard Radio School TV Volunteer Centre Website Word of Mouth Other
• Have you volunteered with our agency before?*
  Yes No
• If so, when and in what capacity?
• Education level completed*
  Junior High School High School College University Post Graduate
• Specialized course / training and if currently a post-secondary student, please indicate what program and year you are currently enrolled in.
• Languages spoken (other than English)
• Work Experience
  Employed Homemaker Retired Self-Employed Semi-Retired Student Unemployed

Employment History

Volunteer Experience

• 
  What other major commitments do you have?*
• Other relevant skills or experiences*

Emergency Contact

• Name
• Day Phone
• Evening Phone
• Cell Phone
• Relationship
• Please explain your reasons for wanting to volunteer with The Support Network. What do you hope to get from this experience? What qualities and skills will you bring to us?*

What feelings come to mind when you think about the following things?

• Family Violence*
• Suicide*
• Child Abuse*
• Sexual Assault*
• Substance Abuse*
• Mental Illness*
• Abortion*
• Sexual Orientation*

• I am willing to sign a contract, upon completion of the agency's training, which will outline the terms and conditions of my volunteer work at The Support Network.*
  Yes No
• I am willing to volunteer at The Support Network at least once a year.*
  Yes No
• Have you had a major life event or loss in the last year?*
  Yes No
• If yes, please describe briefly
• I have a health condition that can be made worse by stress.*
  Yes No
• If yes, please describe briefly
• I have attempted suicide in the past*
  Yes No
• If yes, when?
• I have lost someone close to me to suicide*
  Yes No
• If yes, when?
• Relationship to individual
• I am able to provide pro-choice referrals concerning abortion if asked by a caller*
  Yes No
• Have you ever been convicted of an offence?*
  Yes No
• If yes, what offence and when?
• I am currently seeking mental health care*
  Yes No
• I am willing to submit to a security clearance and child welfare check.*
  Yes No

References

Please ensure you notify your references in advance of our call. Please provide the names of two employment, education or volunteer-related references (not family members or friends)

Reference #1

• Name*
• Day Phone*
• Work Phone
• Email*
• Relationship*
• How long have you known this person?*

Reference #2

• Name*
• Day Phone*
• Work Phone
• Email*
• Relationship*
• How long have you known this person?*

Privacy Policy

The Support Network is committed to protecting the privacy of the personal information of its clients, donors, volunteers, employees and stakeholders. The Support Network values the trust of those we deal with, and of the public. We recognize that maintaining that trust requires that we be transparent and accountable in how we treat the information that you choose to share with us.

We do not share donor or volunteer lists. We do not share, without consent, personal client information with any other organization. Emergency or life threatening situations are the only exceptions to this policy.

By submitting this online form I certify that the statements provided by me are true and accurate to the best of my knowledge. I understand that any falsification on the application will result in my not being considered for a volunteer position with The Support Network.

Confirmation

• The above information is true and accurate.*

About You

Fields marked (*) are required.

• Name*
• Address*
• Address 2
• City*
• Province*
• Postal Code*
• Email*
• Home Phone*
• Work Phone
• Cell Phone

• How did you learn about our volunteer opportunities?*
  Newspaper Poster / Billboard Radio School TV Volunteer Centre Website Word of Mouth Other
• Have you volunteered with our agency before?*
  Yes No
• If so, in what capacity?
• What programs are you interested in?*
  Administration Special Events Board Casino Fundraising Other
• Education level completed*
  Junior High School High School College University Post Graduate
• Specialized course / training and if currently a post-secondary student, please indicate what program and year you are currently enrolled in.
• Languages spoken (other than English)
• Work Experience
  Employed Homemaker Retired Self-Employed Semi-Retired Student Unemployed

Employment History

• Other relevant skills or experiences

Emergency Contact

• Name
• Day Phone
• Evening Phone
• Cell Phone
• Relationship
• Please explain your reasons for wanting to volunteer with The Support Network. What do you hope to get from this experience? What qualities and skills will you bring to us?*

• I am willing to sign a contract, upon completion of the agency's training, which will outline the terms and conditions of my volunteer work at The Support Network.*
  Yes No
• I am willing to volunteer at The Support Network at least once a year.*
  Yes No
• Have you had a major life event or loss in the last year?*
  Yes No
• If yes, please describe briefly
• I have attempted suicide in the past*
  Yes No
• If yes, when?
• I have lost someone close to me to suicide*
  Yes No
• If yes, when?
• Relationship to individual
• I am able to provide pro-choice referrals concerning abortion if asked by a caller*
  Yes No
• Have you ever been convicted of an offence?*
  Yes No
• If yes, what offence and when?
• I am currently seeking mental health care*
  Yes No
• I am willing to submit to a security clearance and child welfare check.*
  Yes No

References

Please ensure you notify your references in advance of our call. Please provide the names of two employment, education or volunteer-related references (not family members or friends)

Reference #1

• Name*
• Day Phone*
• Work Phone
• Email*
• Relationship*
• How many years?*

Reference #2

• Name*
• Day Phone*
• Work Phone
• Email*
• Relationship*
• How many years?*

Privacy Policy

The Support Network is committed to protecting the privacy of the personal information of its clients, donors, volunteers, employees and stakeholders. The Support Network values the trust of those we deal with, and of the public. We recognize that maintaining that trust requires that we be transparent and accountable in how we treat the information that you choose to share with us.

We do not share donor or volunteer lists. We do not share, without consent, personal client information with any other organization. Emergency or life threatening situations are the only exceptions to this policy.

By submitting this online form I certify that the statements provided by me are true and accurate to the best of my knowledge. I understand that any falsification on the application will result in my not being considered for a volunteer position with The Support Network.

Confirmation

• The above information is true and accurate.*

About You

Fields marked (*) are required.

• I am applying as*
  Volunteer Practicum Student Provisional Psychologist
• Name*
• Address*
• Address 2
• City*
• Province*
• Postal Code*
• Email*
• Home Phone*
• Work Phone
• Cell Phone
• How did you learn about our volunteer opportunities?*
  Newspaper Poster / Billboard Radio School TV Volunteer Centre Website Word of Mouth Other
• Have you volunteered with our agency before?*
  Yes No
• If so, when and in what capacity?
• Languages spoken (other than English)

Please fax, mail or email a resume that includes education, employment and volunteer history to:

Coordinator of Volunteers
The Support Network
#301 11456 Jasper Avenue
Edmonton, AB T5K 0M1
Fax: 488-1495
E-mail: volunteers@thesupportnetwork.com

Emergency Contact

• Name
• Day Phone
• Evening Phone
• Cell Phone
• Relationship
• Please explain your reasons for wanting to volunteer with The Support Network. What do you hope to get from this experience? What qualities and skills will you bring to us?*
• Based on your previous experiences as a counsellor, what did you most enjoy?*
• What was most difficult?*
• Are you accustomed to working with team feedback?*
  Yes No
• I am willing to sign a contract, upon completion of the agency's training, which will outline the terms and conditions of my volunteer work at The Support Network.*
  Yes No
• I am willing to volunteer at The Support Network at least once a year.*
  Yes No
• I am willing to submit to a security clearance and child welfare check.*
  Yes No

References

Please ensure you notify your references in advance of our call. Please provide the names of two employment, education or volunteer-related references (not family members or friends)

Reference #1

• Name*
• Day Phone*
• Work Phone
• Email*
• Relationship*
• How many years?*

Reference #2

• Name*
• Day Phone*
• Work Phone
• Email*
• Relationship*
• How many years?*

Privacy Policy

The Support Network is committed to protecting the privacy of the personal information of its clients, donors, volunteers, employees and stakeholders. The Support Network values the trust of those we deal with, and of the public. We recognize that maintaining that trust requires that we be transparent and accountable in how we treat the information that you choose to share with us.

We do not share donor or volunteer lists. We do not share, without consent, personal client information with any other organization. Emergency or life threatening situations are the only exceptions to this policy.

By submitting this online form I certify that the statements provided by me are true and accurate to the best of my knowledge. I understand that any falsification on the application will result in my not being considered for a volunteer position with The Support Network.

Confirmation

• The above information is true and accurate.*