Volunteer Registration Form 
Last name:* First name:*
Street:* Apt: City:*
Home Phone: () - * Business Phone: () - Ext:
Cell Phone: () - Preferred contact: Home Business Cell
Gender: Male Female*
Category: Student Adult*
If you are under 19 years old, please state your age for insurance purposes.
Email Address: *
How often do you check this email address? Daily Every other day Weekly Not very often
How did you learn of this agency? School Newspaper Library Word of mouth TV Brochure*
Do you have any health problems or physical limitations that may affect your volunteer activity?
Additional Languages Spoken: Written:
What type of volunteer work interests you? Please check all that apply.*
Abuse Counselling Administration Animals Archivist
Arts/Crafts Bereavement Counselling Bingo Attendant Board Membership
Bookkeeping Canvasser Carpentry Child Care
Children/Youth Clerical Coach Computers
Dance Data Entry Decorating Education
Entertainer First Aid Flyer Delivery Food & Drink
Friendly Visiting Fundraising Gardening Graphic Arts
Group Leadership Handyperson Homemaking Hospice
Knit/Crochet Languages Library Literacy
Mailings Manual Labour Marketing Mechanics
Museum Music Palliative Care Phone Calls
Public Relations Public Speaking Reception Recreation & Sports
Research Retail Senior's Programs Sewing
Shopper Special Events Coordinator Special Needs Swim Assistant
Telephone Answering Theatre Transportation Woodworking
Work From Home
Do you have any suggestions of volunteer work you would like that haven't been mentioned?
Are there any groups that you would NOT be comfortable working with?
Do you have previous volunteer experience? No Yes, describe:
Do you have any other special skills that you would like to mention?
Do you prefer? One Time Event Only Daytime Evenings Weekends*
What days of the week are you available for volunteer assignments?*
Saturday Sunday Monday Tuesday Wednesday Thursday Friday
Will you be using? Public Transportation Car Both
I understand this application will be held up to 2 years. I agree to allow the information that I have submitted to be used for volunteer referral and to be sent to member agencies. Along with this I allow the Newmarket Public Library to use the information on this sheet for statistical purposes.
Yes No*
By checking this box it is equivalent to your signature and you agree to all of the above. * 4/30/2017
* are required fields