Volunteer Application - Capella Centre

Name*
Date Of Birth*
Email*
Address*
Street Address Address Line 2 City Province Postal Code
Phone*
Alternate
Emergency Contact*
Phone No.
AHC#*
Do you have any medical conditions or allergies you would like us to be aware of?
1. Please outline what you consider to be skills and experience that would be beneficial to the staff and clients at Capella Centre
2. Please tell us what your interests are, and how they pertain to volunteering at Capella Centre
Required: Criminal Record Check and Children’s Services Intervention Check References required