Volunteer Registration Form
Last name:
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First name:
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Street:
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Apt:
City:
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Home Phone: (
)
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Business Phone: (
)
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Ext:
Cell Phone: (
)
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Preferred contact:
Home
Business
Cell
Gender:
Male
Female
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Category:
Student
Adult
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If you are under 19 years old, please state your age for insurance purposes.
Email Address:
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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
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Other:
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.
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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
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What days of the week are you available for volunteer assignments?
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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
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By checking this box it is equivalent to your signature and you agree to all of the above.
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5/23/2013
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are required fields