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charitable registration #11928 4602 RR0001

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Home » Volunteer Application

Volunteer Application

Should you require accommodation during the application process, please inform Fran Savelson at 289-838-4610 so we can ensure your equal participation.

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Contact Information
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 Support
- Hospice Care
- Wellness Support - Reiki Practitioner
- Wellness Support - Therapeutic Touch Practitioner
- Memory Visiting
- Friendly Visiting
- Friendly Visiting - Casual
- Tele-Touch
- Home Support Exercise Program
- Dementia Caregiver Support Group Facilitator
Community * Required
I can volunteer in the following communities:
- Burlington
- Halton Hills
- Milton
- Oakville
- Mississauga (Coptic Adult Day Program Only)
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 don't have it ready, don't worry! You can provide it at a later date.
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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