Victim Services Of Haldimand and Norfolk > Volunteer Info

PART A – GENERAL INFORMATION
Surname*	Given Name*
Home Telephone	Business Telephone
May we call you at work? YesNo
Address
Address2
City	Postal Code

PART B - BACKGROUND INFORMATION
EDUCATION (include highest grade completed, university degrees, relevant courses or training)
EMPLOYMENT (present position, related work experience)
PREVIOUS VOLUNTEER EXPERIENCE (extent of experience, skill, impressions of volunteer work)
COMMUNITY INVOLVEMENT
RECREATION/HOBBIES

PART C - AVAILABILITY
Victim Services is a 24 hour, 7 days a week, on-call service. When are you available to volunteer?	Days
	Evenings
	Overnight
	Weekends
Do you drive? YesNo	Driver's Licence #
How long of a commitment could you realistically make to this service?

PART D - REFERENCE Other than family members e.g. present employer/supervisor, clergy, teacher, etc. Download "Volunteer Reference Check" documents below and email it to info@victimserviceshn.com
In making this application, I give permission to Victim Services of Haldimand & Norfolk to contact the persons named as reference to assess my suitability as a volunteer.*
Also send me a copy
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* Required

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