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VOLUNTEER APPLICATION FORM
Thank you for your interest in volunteering with Reception House Waterloo Region. Please note, some programs have been postponed or adapted due to COVID19. When a position becomes available, we will contact you.
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First Name:
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Your answer
Last Name
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Your answer
Date of Birth
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DD
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YYYY
Preferred pronoun
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She/her
He/him
They/them
Other:
Email Address:
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Your answer
Cell Phone Number:
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Your answer
Other Phone number:
Your answer
Address:
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Your answer
City:
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Your answer
Postal Code:
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Your answer
Native Languages:
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English
Arabic
Amharic
Burmese
Chinese
Dari
French
Hindi
Kurdish
Somali
Spanish
Swahili
Tamil
Tigrinya
Urdu
Vietnamese
Rohingya
Farsi
Other:
Required
Other languages spoken fluently:
Your answer
How did you hear about the volunteer programs at Reception House?
Volunteer Fair / Public Event/ Presentation
Reception House staff
Another volunteer
Website
Social Media
Other
Have you ever been convicted of an offence under the Youth Criminal Justice Act or adult law?
*
Yes
No
What is your COVID-19 Vaccination Status
Unvaccinated
Received Single Vaccine Dose
Fully Vaccinated (2 doses with proof)
Do not wish to disclose
Have a vaccination exemption
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