Children's Safety Village  
of Windsor and Essex County

Nurturing Children's Safety

  7911 Forest Glade Drive

    Windsor, ON N8T 3R7

        Tel: (519) 945-5500

       Fax: (519) 974-7114

          VOLUNTEER APPLICATION FORM   

DATE:     

NAME     

First:             Last:     Middle:

ADDRESS:          

HOME PHONE:     CELL PHONE:     EMAIL:

 

AGE GROUP:     

 

SKILLS & EXPERIENCE:

Present/Previous Employment:

INTERESTS:

Community or volunteer involvement:

Other skills, experience and special interest:

REFERENCES:

                   Name:                                                Address:                                  Telephone:

    1.                  

    2.                  

    3.                  

EDUCATION:

Please give us an outline of your educational background:

AVAILABILITY

Hours of Operation for Day Program are 9.00am until 11.00am & 12 Noon until 2.00pm

Hours for Weekend programming and Special Events will vary.

Monday             Time available       Thursday        Time available   

Tuesday            Time available        Friday           Time available   

Wednesday       Time available   

GENERAL INFORMATION

What type of volunteer work are you willing to do?

Working with Police or Fire Program    Computer (technical)      Camps                   

Special Events                                      Fund Raising Events       Office Work           

Weekend Programs                                General Maintenance (inside or out)              

Other          

How are you involved with this organization?

I am interested in programs related to children and youth   

I regularly attend events that support the Rotary Children's safety village     

 I am a past donor       I am a current donor        I have volunteered in the past   

I occasionally attend events that support the Rotary Children's Safety Village      

 

How did you learn about our volunteer opportunities?       

If other, please specify:

 

Describe what you want to get from your volunteer experience with the Children's Safety Village of Windsor/Essex county, by checking all that apply:

Increase skills (specify what areas):    

Networking opportunities                                                      Social interaction                                      

A sense of  giving something back/being of service        An activity different from my work life       

An activity similar to my work life                                        Other:    

 

DECLARATION

I hereby declare that the above information is true and complete to the best of my knowledge. I understand that a false statement may disqualify me from further consideration as a volunteer or result in dismissal.

Initials:                                Date:

Authorization for collection of personal information: I

(Name of Applicant), authorize Children's Safety Village of Windsor & Essex County to collect personal information appropriate to the position applied for concerning my academic background and employment/volunteering history, and to verify the character references I have supplied. 

 

I understand that the information obtained will be confidential but may be shared with relevant organizations in order to obtain an appropriate volunteer position. 

Initials:                             Date:

PLEASE NOTE: Be sure to log the date and hours you have completed after each shift on a CSV Volunteer Time Sheet provided. This information is important to us as we want to recognize the level of commitment you have given the Children's Safety Village.