MDAO Volunteer Application Form Volunteer Application - 28.5.2013.docx Page 1 of 3

MDAO Volunteer Application Form Name: Address: (Street) (Apt. Number) (City) (Province) (Postal Code) Telephone: (Home) (Mobile) (Work) (Other) Email: Birthday: (DD/MM - optional)

Languages Spoken:

English: Punjabi: German:

French: Spanish: Tagalog:

Cantonese: Italian: Vietnamese:

Mandarin: Arabic: Urdu:

Other:

Emergency Contact & Health Information Contact Name: Telephone: (Home) (Mobile) (Work) (Other) Relationship: Do you have any health-related concerns that we should be aware of? How did you hear about MDAO?

MDAO Volunteer Application Form Volunteer Application - 28.5.2013.docx Page 2 of 3

Please tell us briefly why you would like to volunteer with MDAO: Please describe briefly your previous volunteer and/or work experiences (if applicable): Please describe the kind of volunteer experience you would like to have to MDAO. (i.e. work-related, school-related, want to give back due to personal experience, etc.) Availability as a volunteer (Fundraising/Special Event volunteers must be available on the day of the event as well as for an orientation/training date as required. Leave the schedule blank, if you are only interested in being a Special Event volunteer.)

Time of

Day Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Morning Afternoon Evening

Skills Profile: Check with an “X” the skills that you could confidently use in any volunteer role at MDAO:

Office Technical Special Events Software

Reception Graphic Design Event Planning MS Word

Telephone Peer Support

Web Design Logistics MS Excel

IT Support Raffle Ticket Sales MS Outlook

General Office Work

Internet Research Customer Service MS PowerPoint

Other Cashier Duties Other

Writing/Editing Social Media Fundraising Communications

Communication Twitter Public Relations Newsletters

Group Facilitation Facebook Silent Auctions Webinars

Other Other Setup Public Speaking

If you specified “Other” in any of the categories above, please specify:

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References – please list 3 (i.e. work, volunteer and/or personal) Name Full Mailing

Address Telephone No. Email Relationship

A police records check is required for some volunteer positions. Would you be willing to have a security check completed?

Yes No

Thank you for completing this form. By signing below, you are granting MDAO permission to contact the above references. Signature/Type Your Name (if sending by email) Date