Register Student Volunteer

Create Your Student Volunteer Profile

Personal Details – Adult / Youth under 18 (applicants under 18 must complete a consent form)

Title

First Name

Last Name

Email Address

Phone No

Address Details

Search Address

Suite Number

Address Line 1

Address Line 2

City

Province

Country

Postal Code

No of Years at Current Address (if less than six months, please provide previous address)

Previous Address Details

Address Line 1

Address Line 2

City

Province

Country

Postal Code

Volunteer Details

Age Range

Why do you want to volunteer at De Mazenod Door Outreach?

Volunteer Experience

Role:

Organization:

Date:

Role:

Organization:

Date:

Availability

What time of day are you able to volunteer (please check all that apply)?

Days

Evenings

Weekends

Anytime

Consent For Reference Check

Please provide three (3) references – friends, professionals, work or volunteer associates or ministry leaders. Please refrain from listing your spouse or other family members.

CONSENT:

I authorize De Mazenod Door Screening Committee to contact the references I have provided to collect personal information appropriate to the volunteer position for which I have applied. I understand the information obtained from the reference checks will be kept confidential.

Reference Information

First Name:

Last Name:

Email:

Relation:

First Name:

Last Name:

Email:

Relation:

First Name:

Last Name:

Email:

Relation:

Parental Consent Form

Name of Volunteer

Date of Birth

Volunteer Position

De Mazenod Door

De Mazenod Farm

Parent or Gurardian Name

I give permission for my son/daughter to participate in the above volunteer position(s).
I understand that he or she is expected to comply with the Volunteer Guidelines and the activities and the responsibilities of the position description.
Further, I agree to communicate any significant health problems to the Ministry
leaders. It may also be given to health care professionals in case of an emergency

Health Problems and Allergies

Medication or Treatment

Health Card/OHIP Number

Expiry Date

Physician Name

Physician Telephone Number

Address

Guardian Telephone (Primary)

E-mail Address

Relationship to Volunteer

Emergency Contact Details 1

Name

Address

Telephone (Residence)

Relationship to Volunteer

Emergency Contact Details 2

Name

Address

Telephone (Residence)

Relationship to Volunteer