ALS SOCIETY OF BC VOLUNTEER APPLICATION
When you have completed this form, please fax it to us at 604.685.0725.
Last Name:
First Name:
Street Address:
Province:
Postal Code:
Home Phone:
Business Phone:
Email Address:
Fax Number:
Why would you like to volunteer with the ALS Society of BC?
Do you have a special connection to ALS?
Yes
No
If yes, please explain:
List 3 words to describe your strengths:
List 3 words to describe your weaknesses:
What is your general availability:
Weekday:
Mornings
Afternoons
Evenings
Weekend:
Mornings
Afternoons
Evenings
Please indicate the areas that you are interested in and where you feel you could be most useful:
Media Monitor
Display Booth
Special Events
Fundraising
Office Support
Speakers' Bureau
Support Group Phone Volunteer
Support Group Facilitator
Library
Other (please specify)
Volunteer History
Organization:
Position:
Contact Person:
Telephone:
Duties:
Organization:
Position:
Contact Person:
Telephone:
Duties:
References (not family please)
Name:
Relationship:
Company:
Telephone:
Name:
Relationship:
Company:
Telephone:
Person to contact in case of an emergency:
Name:
Relationship:
Telephone:
Volunteer Agreement
Upon submission of this application, I hereby agree to abide by the policies and procedures of the ALS Society of B.C.
Name:
Date:
ALS Society of BC, 119-1600 West 6th Avenue, Vancouver, BC V6J 1R3, Tel: 604. 685.0737 or 1.800.708.3228 Fax: 604.685.0725 Revised: January 23, 2004.