Inquiry-VOLUNTEER Application - OFFSITE

Please tell us about yourself and your interest in YouQuest:

OFF-SITE VOLUNTEER CONTACT INFORMATION:

FIRST

PHONE

LAST

EMAIL

ADDRESS

CITY

PCODE

PROV

RESUME/HISTORY

Please attach a resume, if available, OR provide your background information below:

YouQuest will reference this information to fully utilize your talents and past experiences.

PROFILE:

Please briefly share your background, employment, interest in dementia, community and/or previous volunteer experience:

SKILLS / INTERESTS:

Please tell us about your skills and interests as a potential volunteer:

REFERRED BY:*

YouQuest website
YouQuest volunteer
Word of mouth
Social Media
Family member
Colleague
Other (see comments box)

For 'Other' sources, please provide details here:

REFERENCES:

Please list two non-family references who will be contacted for further information:

REF #1 FIRST*

REF #2 FIRST*

REF #1 LAST*

*

REF #1 R/SHIP*

REF #2 R/SHIP*

REF #1 PHONE*

REF #2 PHONE*

EMERGENCY CONTACT:

Please provide contact information to be used in the event of an emergency:

Emerg FIRST*

Emerg PHONE*

Emerg LAST*

Emerg ADDRESS*

Emerg R/SHIP*

Preferred START Date

Best time/day to call you:

VERIFIED*

Please read the following carefully before submitting this volunteer application:

I understand that this is an application for and not a commitment or promise of volunteer opportunity. I certify that I have and will provide information throughout the selection process, including on this application for a volunteer position and in interviews with YouQuest that is true, correct, and complete to the best of my knowledge. I certify that I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant for a volunteer position with YouQuest or my termination as a volunteer.

Yes, as a volunteer candidate, I certify the information given to YouQuest is accurate and complete

VOLUNTEER FILE:*

Yes, I understand YouQuest will securely store this information electronically in my volunteer file

DATE

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Comments

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