Thank you for your interest in volunteering at the Michael Garron Hospital

Student After-School Program Application Form

Student After-School Program Application
Personal Information
Last Name:
Given Names:
Date of Birth (mm/dd/yyyy):
Gender:
Contact Information
Address:
City:
Postal Code (e.g. M4C 3E7):
Province (e.g. ON):
Country:
Home Phone:
Mobile:
Work Phone:
E-mail:
Emergency Contact Information
Contact Name:
Relationship To Applicant:
Home Phone:
Mobile:
Work Phone:

Employment
Yes
No
Are you currently employed?
If yes, please fill out the following fields.
Name of Organization:
Current Positon/Title:
From (mm/yyyy):
To (mm/yyyy):
Education
Highest Level of Education Completed:
Are you currently studying?
What school are you attending (if applicable):
Volunteer Experience
Yes
No
Have you had any previous volunteer experience?
If yes, please fill out the following fields.
Name of Organization:
What was your role?
Briefly describe your duties:

Availability
Using the dropbox below, please select your availability from the following days. Volunteers in the student program are asked to commit 2 hours of volunteering once a week. Regular volunteer shift hours are from 4:30 p.m. to 6:30 p.m.

References
Note: Family members may not be used as a reference. To ensure that your application is complete, please provide us with a valid e-mail address for each reference at which we may use for contact purposes.
Reference #1
Last Name:
Given Names:
Reference's Relationship To You:
E-mail Address:
Reference #2
Last Name:
Given Names:
Reference's Relationship To You:
E-mail Address:

Additional Information
Do you play a musical instrument? If yes, please specify:
Yes
No
Are you legally entitled to work in Canada?
If you are over the age of 18 years old, do you consent to a criminal background check?
Yes
No
I understand that there is a minimum 1 year commitment with Michael Garron Hospital.
Yes
No
Are you interested in volunteering in a specific area or is there other information you would like to add?
Yes
No
I declare that all information provided in this application is true and meets the requirement of the program.
Yes
No
I understand that all information is held in the strictest confidence and will only be used to match an individual to a suitable volunteer position, in collection of statistical information or in trending studies.

Thank you for filling out the application. Applications will remain active for a six-month period and applicants will be called based on vacancies and applicant availabliity.


Please note that due to the high volume of applicants, we are unable to follow-up with each applicant individually.


To complete the application process, please submit your application by clicking on the button found at the bottom of the page.