Julliette's Place

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Julliette's Place relies on the on-going support of donors and volunteers.

Current Volunteer Opportunities	Giving Made Easy Donate Online

	Volunteer Application
	All volunteer information is held in confidence and will be used only to match an individual to a suitable position.
	Name:
	Address:			Apt. #:
				City:
	Postal Code:		Province:
	Home Phone:		Fax:
	Work Phone:		E-mail:

	Please state any health conditions that we should be aware of:

	Emergency Contact
	Name:
	Relationship:
	Home Telephone:			Fax:
	Work Telephone:			E-mail:

	Languages Spoken:		English	French
	Other(please specify):
	Age Group:	14-19 20-39 40-59 60+
	Current Occupation:

	Details:
	Details:

	How did you hear about the volunteer program at Juliette's Place?

	My skills are:				My interests are:
	Bookkeeping			Computers	Reading
	Typing			Graphics/Design	Writing
	Finance			Childcare	Music
	Administration			Maintenance	Baking
	Teaching			Cooking	Crafts
	Public Relations			Gardening	Carpentry
	Translation			Fundraising	Gardening
	Event Planning			Other:	Other:

	Availability to volunteer

	Time	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
	Morning
	Afternoon
	Evening

	Previous Volunteer Experience:

	Reasons for selecting Juliette's Place:

	My son/daughter, , has my permission to volunteer in the Juliette's Place volunteer program (if under 16 yrs. of age)
	Parent/Guardian:		Date:
	Emergency Phone Number:

	References: e.g school, work, volunteer
	I agree to have the following references contacted by Julliette’s Place Staff

	1.	Name:		Telephone:
		Relationship:

	2.	Name:		Telephone:
		Relationship:

	3.	Name:		Telephone:
		Relationship:

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