SCARBOROUGH YMCA VOLUNTEER APPLICATION FORM ` PERSONAL INFORMATIONMr. Mrs. Ms. First Name: ????? Last Name: ????? Address: ????? Apartment No.

:????? City: ????? Prov: ????? Postal Code: ????? Home Phone: (??? )??? -???? Cell: (???? )??? -???? Email: ????? Volunteer Shirt Size: ????? Membership #: ????? No Membership| PLEASE LIST TWO REFERENCES (Other than relatives / not related to you)EMAIL REQUIREDMr. Mrs. Ms. (click to see options)Name: ????? Relationship: Phone: (??? ) ??? -???? Email: ????? Notes: (For volunteer coordinator use only)Mr. Mrs.

Ms. (click to see options)Name: ?????Relationship: Phone: (??? ) ??? -???? Email: ????? Notes: (For volunteer coordinator use only)| SCHOOL INFORMATION Not ApplicableSchool Name: ????? How many hours do you require? ????? Time frame: From ????? to ????? (ex. Feb 2010 to Feb 2013)| IN WHICH AREA(S) WOULD YOU LIKE TO VOLUNTEER: (click to see options)Preference #1: Preference #2:| Emergency Contact Information:Name:????? Telephone: (??? )??? -???? Relationship (click to see options) If you have any questions please contact:Scarborough YMCAc/o Myra Narvaza(416) 296-9907 x408myrabelle. arvaza@ymcagta.

org| AVAILABILITYPlease indicate when you would be available to volunteer: Timeframe| Mon| Tues| Wed| Thu| Fri| Sat| Sun| AMBETWEEN6am-10am WEEKENDS 7am-10 am| | | | | | Between| Between| MID #1 BETWEENBetween10am-4pm| | | | | | | | MID #2 BETWEENBetween4pm-8pm| | | | | | | | PMBETWEEN8pm-12am| | | | | | | | | OTHER INFORMATION (Volunteer Coordinator Use Only) INTERVIEW DATE: _________________________ AGEDate of Birth:______________________Current Age: ______________________ * 14 – 15 yrs. Proof of Age: ____________________16 yrs. n:______________ * 16 above; Clearance Letter Date: ________________ MEDIA RELEASE FORM DATE: ______________________ AODA SELF-STUDY CONFIRMATION EMAIL DATE: _____________________ CERTIFICATION / QUALIFICATIONS: ______________________________________Tentative Assignment: (Program Area //Day/s //Time/s) ____________________________ NOTES:| ORIENTATION INVITE EMAIL DATE: ________________________ Volunteer Operating Policies Procedures Manual copy AODA Self Study linkORIENTATION DATE & TIME: ______________________________|