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

Adult Program Application Form

Adult Program Application
Personal Information
Prefix/Title:
Gender:
Last Name:
Given Names:
Date of Birth (OPTIONAL) (mm/dd/yyyy):
Contact Information
Address:
City:
Postal Code (e.g. M4C 3E7):
Province (e.g. ON):
Country:
Home Phone:
Mobile:
E-mail:
Work Phone:
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
Have you had any previous volunteer experience?
Yes
No
If yes, please fill out the following fields.
Name of Organization:
What was your role?
Briefly describe your duties:

Availability
Morning
Afternoon
Evening
Monday
Morning
Afternoon
Evening
Tuesday
Morning
Afternoon
Evening
Wednesday
Morning
Afternoon
Evening
Thursday
Morning
Afternoon
Evening
Friday
Morning
Afternoon
Evening
Saturday
Morning
Afternoon
Evening
Sunday

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?
Yes
No
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.
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.