Volunteer Application

Personal Information

First Name *

Last Name *

Nickname

Unit/Apt #

Address *

City *

or other city:

Prov *

Postal Code

Phone 1 Type *

Phone 1 # *

Phone 2 Type

Phone 2 #

Email *

Birth Date *

mm/dd/yy

Gender *

Health Concerns/Special Needs *

Enter any allergy, health, mobility concerns, etc. we should be aware of. Please enter None if there are none.

Interests/Experience/Skills

Other program(s) you are interested in not listed above:

Why do you want to Volunteer at Place des Arts? Select all that apply *

To complete my work experience or volunteer hours for school

To learn about my own strengths and weaknesses

To learn more skills and gain experience

To make a difference in the community

To meet new people

To support arts and culture

To volunteer with my friends

Other reasons to volunteer not listed above:

Do you speak any languages other than English?

List all and indicate what level.

Other special skills or qualifications you have not listed above:

Previous Volunteer or Work Experience *

References

Please provide name and contact information for a personal and professional reference. Family may not act as references.

1st Reference Contact: First Name *

1st Reference Contact: Last Name *

1st Reference Contact: Relationship *

1st Reference Contact: Phone # *

1st Reference Contact: Email

2nd Reference Contact: First Name *

2nd Reference Contact: Last Name *

2nd Reference Contact: Relationship *

2nd Reference Contact: Phone # *

2nd Reference Contact: Email

Emergency Contacts

Please provide name and contact information for who to contact in case of an emergency.

1st Emergency Contact: First Name *

1st Emergency Contact: Last Name *

1st Emergency Contact: Phone 1 # *

1st Emergency Contact: Phone 2 #

1st Emergency Contact: Relationship *

Volunteer Form

Volunteer Application

Personal Information

Interests/Experience/Skills

References

Emergency Contacts