Volunteer Application Form - BGC South Coast BC

Date:

Name:

Are you 19 or older?

Address:

City:

Postal Code:

Preferred Club Location

Phone Number:

Email:

Date:

Emergency Contact Information

Full Name:

Relationship to You:

Phone Number:

How Did You Hear About Our Volunteer Opportunities?

Occupation:

Does Your Current Employer Offer a Volunteer Incentive Program?

Languages

Spoken:

Written:

Special Training, Skills, Hobbies, or Interests:

If you selected "Other" please specify:

If interested in Club volunteering, is there a particular location you would like to volunteer at? Please specify:

Which Volunteer Opportunity are you interested in applying for? You can select multiple positions:

Times:

Mornings Afternoons Evenings

DECLARATION:

I HEREBY DECLARE that the information I provided in this application 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 my dismissal.

Name:

Date:

AUTHORIZATION FOR COLLECTION OF PERSONAL INFORMATION:

I (Name) AUTHORIZE Boys and Girls Clubs of South Coast BC to collect personal information appropriate to the position applied for concerning my 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.

PUBLICITY CONSENT AND SURVEY:

Some of our funding opportunities require testimonials and event photos for funding, brochures and/or displays. In addition to this, as part of our accreditation of services we are required to survey past and present volunteers.

I (Name) hereby give the BGC consent to use and reproduce my image for promotional purposes related to BGC. This may include photography, film, video, etc taken during my duties as a BGC volunteer. I release BGC and its agents from any and all claims of any nature based on any uses of the above.

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