Canadian Longevity Association Volunteer Registration Form
Thank you for expressing an interest in volunteering for the Canadian Longevity Association.

It is only through our combined efforts that we will be able to end the scourge of aging related diseases and give ourselves and our loved ones increased healthy longevity.

The journey will be long and arduous, but every journey begins with a step - such as the step you are taking now by filling out this form!

Once you have filled out this form, we will contact you to give you a choice of volunteer activities to help us with.

*Your information will be kept confidential and not be passed on to any third party. It will solely be used by the Canadian Longevity Association.
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Email *
Your Last Name / Family Name *
Your First Name *
Any Nickname or Name You Wish To Be Called By
Your Phone Number
How Else Can We Reach You? FB Messenger, Discord, LinkedIn etc.
Website or Social Media Profile (can add multiple)
Province, Territory or Country *
City *
Street Address
Postal Code
Your Education (with degree if you have one) *
Languages Spoken, Other Than English
Current Job or Profession (or none! :) ) *
Professional Skills From Your Current Job *
Other Skills, Knowledge or Abilities *
Any Skills You Would Like To Acquire or Develop
Your Hobbies or Interests
How Did You Find Out About The Canadian Longevity Association? *
Why Do You Want To Help Our Organisation Improve The Healthy Longevity Of All Canadians? *
Ideally, How Would You Like To Help Us? (Tick all that apply) *
Required
Any Additional Ways You Can Help?
How Much Time Do You (Realistically) Have Available To Help Us? *
Are There Any Specific Days or Times When You Would Be Available To Help?
Is There Anything Else You Would Like To Tell Us About Yourself?
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