Sustainable Living Network

Volunteer Application

First Name: __________________________ Surname: ____________________________

The following information request is to help us have a better understanding of who you are, and important attributes that can affect your relationship with us. We gather it to help us do our job better. If there is anything that you feel uncomfortable declaring, either do not fill it out, or better yet, please talk with us about it.

Age: ____ Marital Status: ______ # of Dependants: ______

Nationality: _____________________ Permanent Resident of Canada? (Yes/No) __________

Do you have a work Visa? (Yes/No) ______ Expiry Date: ______________________________

Address: ______________________________ City: ________________ Postal Code: __________

Phone: Home _____________________ Work ___________________ Cell ______________________

Email: _____________________________________ Web site: ________________________________

Medical conditions (allergies, etc.) or special needs? ________________________________________

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Emergency Contact: ___________________ Relationship:_____________ Phone: _________________

How did you first learn of the Sustainable Living Network? ______________________________

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Why do you want to volunteer? (Please also see question below) _____________________________

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What would you like to gain from a volunteer position with the Sustainable Living Network? ____________________________________________________________________________

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In what capacities (e.g. projects) might you contribute to the work of the Sustainable Living Network? (Please refer to the documents under technical volunteering at www.sustainablelivingnetwork.org) ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Availability for volunteering (mark an “x “ for all that apply, with a corresponding number for priority (e.g. ‘x1’ = best time for volunteering):

Mon. Tues. Wed. Thur. Fri. Sat. Sun.

Morning (9 – 12)

Afternoon (12 - 5)

Evening (5/6-8/9)

Frequency of Availability (e.g. daily, weekly, semi-weekly, etc.): __________________________

Commitment Length: (Check appropriate one) July __ July & August __ Fall 2006 __ Winter 2007 ___

Start Date: ____________________ End Date: (Not necessary if no hard end date) ________________

What are your personal commitments (family, job, others volunteer work, etc.) ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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What do you need in terms of understanding, support, etc. from us in order to be a successful volunteer? ___________________________________________________________________

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* Please append a recent copy of your resume to this application. Whatever information is covered in the resume need not be filled out in the form below, unless you would like to repeat it and/or highlights certain aspects of your resume. If you do not have a resume, please fill out the fields below in detail.

Past Volunteer Experience (include organization/agency, position, supervisor contact info):

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Employment (most recent, include: company, position, supervisor contact info):

1._______________________________________________________________________________________________________________________________________________________

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2._______________________________________________________________________________________________________________________________________________________

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List relevant employment experiences (and/or complete table below): ______________________

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List platforms and programs that you can use, and corresponding years of experience, level of knowledge (and applicable projects if possible and/or not stated elsewhere).

Operating Systems	# of Years	Relevant Projects
Programming Languages	# of Years	Relevant Projects
SoftwarePrograms	# of Years	Relevant Projects
Protocols

Education/Credentials (include high school and education in progress):

Degree Date of Completion School Location

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What personal interests or hobbies relate to your desired volunteer position? _______________

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List several character traits that have been helpful in volunteer/work/educational environments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

References (list two non-family members who are familiar with your character and abilities and have agreed to provide a reference for you):

Name Relationship Phone

1.______________________________________________________________________

2.______________________________________________________________________

Declaration

I hereby declare that the above information is true and complete to the best of my knowledge. I understand that a false statement may disqualify me from further consideration as a volunteer or result in dismissal.

I, ____________________________________, authorize The Sustainable Living Network to collect personal information appropriate to the position(s) applied for concerning my academic background and employment/volunteering history, and to verify the character references I have supplied. The Sustainable Living Network adheres to the Protection of Privacy Act and the Freedom of Information and Protection of Privacy Act.

I understand that a Police Record Search is required for potential volunteers who are applying for positions that are considered to have, or potentially have, interaction or contact with children, youth and other vulnerable groups.

Volunteer placement is made on the basis of the program requirements, the skills and experience of the applicant and, when appropriate, successful reference checks and a police record search.

Prior to placement written parental/guardian consent is required for volunteers under age 19.

Applicant Signature:	Date:
Witness for the Sustainable Living Network: Signature:	Print Name:

Please submit the Volunteer Application along with a copy of your resume to:

Jillian Hovey, Executive Director of The Sustainable Living Network

email: jillian@permaculture.net , fax: 416-654-8917

or mail to the address below: 78 Alberta Avenue, Toronto, ON M6H 2R8

Tel: 416-410-7581 www.sustainablelivingnetwork.org