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Become a volunteer

* Required information

Your Personal Details

Gender *
Firstname *
Lastname *
Date of birth
* (ex. 21/05/1970)
Email address *

Your contact details

Address *
Suite
Postal code
City *
Province *
Country
Work phone *
Telephone
Cellular
ignorer

Volunteer's profil

Spoken languages *
  French   English
  Other
Health
Occupation *
  At home   Student
  Working   Unemployed
  Retired   Other
Last level of study completed *
  Primary   Secondary
  College   University
Field of study
Which of the following has informed you that we are looking for volunteers? *
  An advertisement   A brochure or poster of the Center
  Another organization   A relative, a friend
  Other
Person to contact in case of emergency *
Do you have a car? *
  Yes
  No
Are you ready to use it for volunteering? *
  Yes
  No
Have you ever volunteered? *
  Yes
  No
Personal references or volunteer experience
Name of the organization Position Year Duration Tel. (if necessary)
Which of the following volunteer activities interest you ? *
  Medical and social Accompaniment/transport   Friendly visit
  Responsible for Meals on Wheels   Deliver meals on wheels
  Senior’s Volunteer committees   Daily phone call
  Small services   Little Frozen Meals / Assistant-cook
  Little Frozen Meals / Preparation of commands   Little Frozen Meals / Delivery
  P’tit Bonheur / social-accompaniment   P’tit Bonheur / Respite – child care
  P’tit Bonheur / Accompaniment-transport   P’tit Bonheur / Clothes for 0 to 6 years
  P’tit Bonheur / Cleaning baby toys and baby equipments   Accompaniment in palliative and end-of-life care
  Guignolée, Christmas food card   Board of directors
  Technical support and occasional activities   Translation and correction
  Fundraiser
For which clientele would you like to offer your services? *
  The elderly   Sick people
  People with physical disabilities   People with intellectual disabilities
  People with mental health problems   Adults in difficulty
  Families in difficulty   Young people from 7 to 17 years old
  Children from 0 to 6 years old   Organizations
Other relevant information about you

CONFIDENTIALITY OF PERSONAL INFORMATION *

The Centre d’action bénévole Saint-Siméon/Port-Daniel is committed to ensuring the confidentiality of your personal information.
If you are referred to another organization, do you authorize the Centre d’action bénévole Saint-Siméon/Port-Daniel to transmit the information collected during the orientation process?
  I agree   I disagree

The centre d’action bénévole Saint-Siméon/Port-Daniel…

volunteer hours
0
Accompaniement-transport services
0
Home meals served
0

...At the heart of the community.