Volunteer Application | The Golden Circle

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You are here: Home1 / Volunteer & Employment2 / Volunteer Application

Your Personal Information

Your Name

First Last

Your Email Address

Enter Email Confirm Email

Address

Street Address Address Line 2 City Province Postal Code

Home Phone

Cell Phone

School Name (if currently a student)

Program enrolled in (if currently a student)

Volunteer Experience

Your Volunteer Experience

Please list your previous volunteer experience, the dates you volunteered and the duties performed. Click + to add second and third references.

Organization

Dates

Position/Duties

References

Please supply 3 references, at least 2 of which live in Red Deer that we may contact. Click + to add additional entries.

Name

Phone Number

City

Volunteer Questionnaire

Do you have any experience with Seniors?

Yes

No

Great! Please describe any special skills that you feel would be relevant.

Why do you want to volunteer with Seniors?

Are you willing to submit a criminal background check?

Yes

No

What days and times during the week would be convenient for you to do your volunteer work?

Please provide available hours under the appropriate day(s).

Mondays

Tuesdays

Wednesdays

Thursdays

Fridays

Saturdays

Sundays

Are you available throughout all the months of the year?

Yes

No

If no please specify which months you are not available.

How did you learn about our volunteer program?

Please list any hobbies, interest and activities that you enjoy:

What kind of volunteering would you like to do?

Supportive transportation

Bingos

Lunch cash

Kitchen

Friendly visitor

Senior lunch express

Special events

Rebel hocky program

Deliver groceries

Banquets

Programs or Classes

Other

If other, please list

If you have your own vehicle, would you be interested in assisting with transporting seniors to functions or appointments?

No

Yes

If yes, how many passengers does your vehicle seat?

Are you able to carry a wheelchair?

Yes

No

Are you able to carry a walker?

Yes

No

Do you have a valid drivers license?

Photocopy of license required

Yes

No

Is your vehicle registered?

Photocopy of registration required

Yes

No

Do you have a minimum of $1,000,000 liability on your insurance policy?

Photocopy of insurance required

Yes

No

Terms and Conditions(Required)

I hereby acknowledge that the above information is accurate and true and that if any information has been falsely disclosed, it is cause for termination as a Golden Circle Volunteer.

I agree to the terms and conditions.

Personal information provided here will not be used for purposes other than those related to the Golden Circle Senior Resource Centre. Your information will be handled with respect, and will not be sold, given away, or provided to parties outside of the Golden Circle Senior Resource Centre without your consent, unless law required that it be shared.

The Golden Circle is grateful for funding provided by the Government of Canada’s Community Services Recovery Fund.

Funded by the Government of Canada's Community Services Recovery Fund

We’d like to thank Red Deer & District Community Foundation for their work in the Community Services Recovery Fund and their continued support for the Golden Circle.

Office Hours

Monday 8:30 am – 4:30 pm
Tuesday 8:30 am – 4:30 pm
Wednesday 8:30 am – 4:30 pm
Thursday 8:30 am – 4:30 pm
Friday 8:30 am – 4:30 pm

Contact

403-343-6074
Contact Us
4620 47A Avenue
Red Deer, Alberta
Canada T4N 3R4

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