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Volunteer Application Form
Alzheimer Society Peel (ASP) is committed to protecting your privacy and your personal information. The information you provide will be used for the purpose of establishing, managing and/or termination volunteer relationship between the Society and you. We also may use the information to keep you informed on activities including programs, services, special events, funding needs, opportunities to volunteer or to give. All files are confidential; only authorized persons who need to consult this information in the course of the recruitment     and/or volunteer process may gain access to it.               
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First Name *
Last Name  *
Phone number *
Email *
Are you 18+ applicant?  *
Are vaccinated against Covid-19 minimum 2 shots? *
Are you seeking volunteer hours as part of community service requirements? i.e. secondary school, college/university, court ordered? *
Required
If answered yes, please identify requirements 
Which position(s) are you interested in? *
Required
If applicable, please select sites of interest
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What is your preferred times/days? * Note Adult Day Programs hours of operation hours - 7:30am to 5:30pm. Nora's House - Respite Care 24/7. *
EMPLOYMENT AND VOLUNTEER HISTORY: Starting with your most recent employer, provide the following details:  
  Additional Information you feel we should know: including educational background, current licences, certifications etc.   
  Are you legally able to work/volunteer in Canada?   
 *
  Have you been convicted of a Criminal offence for which a pardon has not been granted?   
 *
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