Volunteer Application 1. Applicant infoName* Address* City/Town* Province* Postal Code* Email Address* Phone Number* 2. Emergency ContactName Email Address Phone Number 3. Volunteer OpportunitiesCheck all that apply Friendly Phone Calls Grocery Shopping and Delivery Pick-up and Delivery Tax preparer Phone Host for our Telephone Social Programs Online Host for our Online Social Programs *4. Confidentiality Agreement:Please read and check if you agree to the statement belowI have read and agree to the above statement* I have read and agree to the above statement 5. Checklist & Agreement for Volunteers Providing ServicesEmergency COVID-19 Response Services "Safe Seniors, Resilient Communities"Checklist & Agreement* I give permission to Seniors Outreach and Resource Centre to conduct a background check that includes a criminal record check and two reference checks. The offer to volunteer with Seniors Outreach and Resource Centre is conditional on the satisfactory results of background checks to be conducted. Volunteer shifts will not start until Seniors Outreach has reviewed the background check results to its satisfaction. Complete the COVID-19 Self- Assessment Tool- Found at: https://bc.thrive.health/ Reassess your health just prior to completing any volunteer task. If you're ill, please stay home! Read and understand the organization policy review and agreement (Q.7) Read and Understand this confidentiality agreement: Respect for confidentiality is the cornerstone of trust and confidence, as well as a legislated obligation. The confidentiality of participant information; therefore, for all information shared by the program participant/family is confidential. Breach of confidentiality may result in disciplinary action, up to and including termination of placement or contract. By signing, I confirm that the information in this volunteer application is complete and true. I understand and agree that any omission or misrepresentation may be cause for refusal of volunteer placement. I understand that a Vulnerable Sector Record Check is required for all positions. CLICK to indicate Electronic Signature.