Volunteer Application

Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

Area Code Phone Number

E-mail *

Are you over the age of 18? *

Yes No

If you are not over the age of 18, how old are you?

How did you hear about volunteering for Learning Disabilities Red Deer? *

Tell us why you would like to volunteer for Learning Disabilities Red Deer. *

Please list qualification, experience, and skills which you feel would contribute to your participation as a volunteer for Learning Disabilities Red Deer. *

Please list any previous volunteer experience you have.

What days and times are you available to volunteer? *

Do you own a vehicle? *

Yes No

If you own your own vehicle, are you willing to provide your own transportation for volunteer purposes, example: picking up items for a fundraiser?

Yes No

Please provide the name, addresses, and phone numbers for two references.(Other than family members) *

*Which area/areas would you like to volunteer *

Tutoring Casino Special Events Bottle Drive All of the Above

*Some volunteer roles require a criminal records check and application process.

The Learning Disabilities Association of Alberta values the privacy of its members and volunteers and will not release your personal information to other organizations. The Learning Disabilities Association of Alberta - Red Deer Chapter gathers information about its members and volunteers in order to develop programs and services. Please indicate your agreement to receive e-mails from Learning Disabilities Association - Red Deer Chapter by inserting your name below. E-mails will be for program information, fundraising, volunteer opportinities and other information for members and volunteers only.

Signature(Please insert your name) *

Date *

Month Day Year