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charitable registration #11928 4602 RR0001

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- - Home Care – Nursing, personal support and companions to keep you healthy and well.
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- - Dementia Care – The help you need to care for your loved one living with dementia (such as Alzheimer disease).
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    - Home Support Exercise Program
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Home » Volunteer Application

Volunteer Application

Should you require accommodation during the application process, please inform Tanya Peche Hopley at 905-827-8800 x2329, so we can ensure your equal participation.

Step 1 of 7

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Contact Information
Full legal name * Required
First Last
Email * Required
Main Phone * Required
Other Phone, please specify:
Address * Required
Street Address Address Line 2 City Province / State Postal / Zip Code Country

Program Choices
Programs currently accepting applications: * Required
- Bereavement Peer Support
- Friendly Visiting
- Home Support Exercise Program
- Hospice Care
- Memory Visiting
- Tele-Touch
- Wellness (Reiki and Therapeutic Touch)
Are you certified Reiki Level 2 or higher? * Required
Are you certified Therapeutic Touch™ level 2 or higher? * Required
Community * Required
I can volunteer in the following communities:
- Burlington
- Halton Hills
- Milton
- Oakville
Availability * Required
I am available to volunteer:
- Weekday Mornings
- Weekday Afternoons
- Weekends
Transportation * Required
Some of our programs require transportation. Do you have access to a vehicle?

Volunteer Experience
Current Volunteer Positions
Please list role and organization:
Past Volunteer Positions
Please list role and organization:

Work Experience
Current Work Positions
Please list role and organization.
Past Work Positions
Please list roles and organizations.

Skills and Abilities
What languages do you speak?
What are your interests, special skills and abilities?

Other Information
Your Resume
Please upload your resume here if you would like to include it. It isn’t required.
Drop files here or

Max. file size: 40 MB.
Have you been referred by an Acclaim Health volunteer or staff member?
If so, please provide their name so we can thank them.

Permissions
Permission to Email
- I agree
Email is the main form of communication with our volunteers and it's how you will find out about upcoming workshops, events and major news regarding the organization. You can unsubscribe at any time, but this may result in you missing out on important stuff.
Permission to Submit * Required
- I agree
Acclaim Health is committed to individual privacy and has taken reasonable precautions to ensure the security of the information you are submitting through this online form. By clicking "I agree" you are acknowledging and accepting the potential risks inherent in submitting personal information and/or personal health information online. Please contact us by telephone at 905-827-8800 if you do not wish to submit this information online and we will be happy to assist you.
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Email
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Contact us to learn more.
905-827-8800 or 1-800-387-7127

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Charitable Registration #: 11928 4602 RR0001
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