Volunteer Application - Acclaim Health

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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 Postal Country

Select Which Volunteer Programs You're Interested In

Where would you like to volunteer? * Required

Adult Day Programs

The community

Which program(s) are you interested in applying for? * Required

Friendly Visiting Volunteer

Memory Visiting Volunteer

Technology Accessibility Program (TAP) Volunteer

Tech Café Volunteer

Wellness Volunteer (Reiki and Therapeutic Touch)

Community Services Placement Student

Bereavement Peer Support Volunteer

Home Support Exercise Program

Hospice Care Volunteer

Tele-Touch – Phone Volunteer

Which communities would you like to volunteer in? * Required

Burlington

Halton Hills

Milton

Oakville

Availability: * Required

Weekday Mornings

Weekday Afternoons

You must be 18 years or older to apply for this program. Are you 18 years or older? * Required

Yes

Which program(s) are you interested in applying for? * Required

Adult Day Program Volunteer

Adult Day Program Lunch Support Volunteer

Which Adult Day Programs would you like to volunteer in? * Required

Burlington Club (Upper Middle Rd/Appleby Line)

Mississauga Club (QEW/Winston Churchill Blvd)

Availability: * Required

Weekday Mornings

Weekday Afternoons

Weekday Evenings

Weekends

Transportation * Required

Some of our programs require transportation. Do you have access to a vehicle?

We’re sorry, you must be 18 years or older to apply to volunteer at one of our Adult Day Programs. We look forward to receiving your application in the future!

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: 256 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

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.

I agree

Permission to Submit * Required

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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Name

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Contact Information

Select Which Volunteer Programs You're Interested In

Volunteer Experience

Work Experience

Skills and Abilities

Other Information

Permissions

Contact us to learn more. 905-827-8800 • 1-800-387-7127

Contact us to learn more.
905-827-8800 • 1-800-387-7127