VOLUNTEER APPLICATION FORM

Name: Address: Home Phone Number: Cell Phone Number: Please specify which days you are available:

Please specify which hours you are available:

Please specify any areas you are interested in volunteering in:

Please specify any hobbies you have:

Please provide names and numbers for three references:

1.

2.

3.

Please provide the following documents:

• Criminal Record Check (original)

• Immunizations Record (copy)

• Confidentiality Form

PO Box 790

Fort Macleod AB T0L0Z0

Pioneer Lodge

Colonel Macleod Manors 1 and 2 Chinook Arch Manor

Administration: 403 553 3662

Fax: 403-557-5258