Volunteer Application Form

PERSONAL INFORMATION

Title:

If you answered with "other," please write your response here:

Address. Example: 259 Foster Thurston Drive, Saint John, New Brunswick, E2J 1K3.

Mailing/Delivery address (if different from above):

Relationship to Volunteer:

How did you find out about the Heart and Stroke Foundation of New Brunswick (HSFNB)?

YOUR AVAILABILITY

Why do you want to volunteer for HSFNB?

Which day(s) of the week are you available to volunteer (check all that apply):

What time(s) of the day are you available on these days (check all that apply):

Are there times during the year that you are unable to volunteer (e.g. summer, March Break)?

YOUR PREFERENCES

Are you interested in volunteering on a (check one):

Short-term basis (up to 6 months)

Longer-term basis (longer than 6 months)

Seasonal/Occasional basis (as needed & available)

Regular basis (in the office)

CURRENT EMPLOYMENT

Please list your position, department and division:

The address of your place of employment. Example: 259 Foster Thurston Drive, Saint John, New Brunswick, E2J 1K3.

COMMUNITY AFFILIATIONS

Please list any Service Clubs and/or other charities you volunteer with:

OTHER INFORMATION

Please list two people as references. One can be a personal reference; one must be a professional reference. Please include their name, phone number and how many years they've known you.

VOLUNTEER AGREEMENT – Please read the following and check to verify that you have read the information:

1. I understand that my participation is purely voluntary and that there will be no financial remuneration whatsoever.

2. I understand while representing the Heart and Stroke Foundation of New Brunswick I must conduct myself in an acceptable and professional

3. If accepted as a volunteer, I agree to sign a confidentiality agreement.

4. If accepted as a volunteer, I agree to provide the Heart and Stroke Foundation of New Brunswick a Criminal Record Check / Vulnerable Sector Check.