Good Neighbour Project - London Volunteer Intake Form
On behalf of the Good Neighbour Project, thank you for volunteering to assist with a delivery to someone in need! We want to make sure that this is a safe process for both you, the volunteer, and for the person who has requested assistance.

Please read the following volunteer requirements:

Health: You cannot volunteer if you are currently experiencing any of the following symptoms:

- fever
- shortness of breath or difficulty breathing
- fatigue
- flu-like symptoms
- upper respiratory symptoms
- you have had close contact with someone in self-isolation or who is experiencing any of the above health symptoms
- you have had close contact with someone who is waiting for test results or has otherwise been diagnosed with COVID-19

Travel: You cannot volunteer if any of the following apply to you:

- you have traveled outside of Canada in the last 14 days
- you have had close contact with anyone who has traveled outside of Canada within the last 14 days
- you have been in a crowd with 200+ people within the last 14 days

Age: Volunteers must be 18 + years old.

Please refer to the Government of Canada ( website for health guidelines in reference to people who need to self-monitor or self-isolate. People who need to should not be volunteering for this initiative.

Making the delivery:

The Good Neighbour Project requires that all volunteers follow specific procedures to ensure that deliveries are done as safely as possible. You must review the Good Neighbour Project's Volunteer Delivery Guidelines document in its entirety before beginning a delivery. This document will be sent to you by one of our coordinating volunteers.

Should you have any questions regarding the Good Neighbour's volunteer requirements or policies, please do not hesitate to ask. Inquires can be directed to
Full Legal Name *
Facebook Username *
Phone Number *
Format: xxx xxx xxxx
E-mail Address *
Full Address: *
(Street name and number, Unit number if applicable, City, Postal Code)
Language(s) Spoken: *
Please list any language you can comfortably communicate in.
Are you able to do deliveries in London, ON? *
Are you interested in doing outreach? *
We would like to proactively identify which areas may require additional assistance with getting access to groceries, supplies, and donations. We are trying to build a network that can assist vulnerable people in being connected with the support they need. We are looking for volunteers who will work with us to implement outreach strategies to support and resource networks in the months to come.
Please provide two (2) character references that we can contact. *
Please provide: name, phone number, email address and relationship to you
Have you read the volunteer requirements above and, to the best of your knowledge, do you meet all of the requirements? *
Confidentiality Agreement: I, the undersigned, in the course of volunteering with the Good Neighbour Project, hereby acknowledge and agree to the following: I shall not, at any time during or subsequent to this participation, make unauthorized disclosures or unauthorized use of any information that is considered confidential or proprietary. Examples include, but are not limited to: names, addresses, and phone numbers of anyone requesting assistance. I will also not make further contact or communication with the requester once the delivery is complete. *
Enter your full legal name if you agree to the above.
Safety & Security Agreement: I, the undersigned, hereby acknowledge that I am fully responsible for my safety and security, as well as that of my personal belongings, while fulfilling a volunteer delivery. I specifically waive all rights, liabilities, claims and/or actions against all organizations, communities, and affiliates part of the Good Neighbour Project. *
Enter your full legal name if you agree to the above.
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