Volunteer Application 1. Applicant infoName*Address*City/Town*Province*Postal Code*Email Address*Phone Number*2. Emergency ContactNameEmail AddressPhone Number3. 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. Reference 1NameRelationshipEmail AddressPhone Number5. Reference 2NameRelationshipEmail AddressPhone Number*7. Confidentiality Agreement:Please read and check if you agree to the statement below* I have read and agree to the above statement 8. Checklist & Agreement for Volunteers Providing ServicesEmergency COVID-19 Response Services "Safe Seniors, Resilient Communities"* Vulnerable Sector Check (Criminal Record Check) Completed 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.