Volunteer Application - Brain Injury Association of London & Region

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Thank you for your interest in volunteering with us! By filling out this application form, you'll help us learn more about your skills, interests, and availability. Your support is essential in advancing our mission to make a positive impact in the community. We look forward to working together to create meaningful change!

APPLICANT INFORMATION

Name (First and Last) *

Address (Street, City, Postal Code)

Phone Number *

E-Mail Address *

Preferred method of contact *

Phone

Required

Are you 18 years old or older? *

Yes

Required

EMERGENCY CONTACT

In the event of an emergency, having this information allows us to quickly reach a designated person to provide assistance if needed.

Name (First and Last)

Address (Street, City, Postal Code) *

Phone Number *

VOLUNTEER INTERESTS AND SKILLS

Why do you want to be a volunteer at BIALR? *

Are you comfortable using any of the following computer programs? *

Yes

Word Processing

Excel - Database Maintenance

PowerPoint

Google Suite/Google Drive

Mailchimp

Adobe Acrobat

WIX

What other skills/training do you believe you have that would be an asset to our organization and its members? *

What area(s) are you interested in volunteering in? Check all that apply. *

Fundraising Committee (assist planning annual events and fundraisers)

Governance Committee (assist with developing and updating policies and by-laws)

Support and Programming Committee (assist overseeing new programs and services)

Conference Committee (assist with planning annual ABI conference)

Office Administration (volunteer in office or work remote, filing documents, updating databases)

Informal Research (assist with various projects)

Support Group Leader / Co-facilitator (volunteer at a monthly support group)

Auction Item Donation (assist securing donated auction items)

Event Volunteering (in person, assist with setup/tear down, welcome desk, selling tickets)

Required

When are you available to volunteer (days of the week, special events, etc.)? *

Are you currently volunteering with, or have you volunteered at other organizations in the past? *

Yes

Required

If yes, please provide details:

It may be necessary to complete a Police Records Check for a volunteer position. Do you agree to this condition? *

Yes

Do you have reliable transportation to volunteer assignments? *

Yes

Do you have a personal laptop or computer that you can use for association related assignments, if required? *

Yes

EMPLOYMENT HISTORY

Please list current or last employer

Employer - Name of Organization *

Name and Title of Supervisor *

Start and End Dates of Employment *

Job Title and Duties Performed *

REFERENCES

Please provide the names of three individuals, excluding relatives and employers, whom you have known for at least two years and who are familiar with you well enough to serve as references.

By providing this information, I am giving permission for a representative of the BIALR to contact the person(s) below for the purpose of checking my references to determine my suitability for a volunteer position with the Association.

REFERENCE #1 - Name (First and Last) *

REFERENCE #1 - Phone *

REFERENCE #1 - Relationship to you *

REFERENCE #1 - How long have you known this reference? *

REFERENCE #2 - Name (First and Last) *

REFERENCE #2 - Phone *

REFERENCE #2 - Relationship to you *

REFERENCE #2 - How long have you known this reference? *

How did you hear about us? *

Electronic Signature *

Date Application Completed *

YYYY

Submit

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