ADDRESS:

CITY:

PROVINCE:

POSTAL CODE:

HOME PHONE:

BUSINESS PHONE:

EMAIL:

LANGUAGES; SPEAK FLUENTLY:

HAVE YOU WORKED WITH REFUGEES BEFORE?
YES NO

PLEASE LIST ANY EXPERIENCE WHICH YOU FEEL IS RELEVANT:

HOW DID YOU HEAR ABOUT CCVT?

WHAT PROMPTED YOU TO GET IN TOUCH WITH US?

AREAS OF INTEREST (please indicate one or more areas which you feel you have time to dedicate to)
BEFRIENDING (offering ongoing personal support for a survivor)
INTERPRETING /ESCORTING (usually weekdays, during office hours)
ESL TUTOR (weekly session with an individual client)
PUBLIC EDUCATION (information tables, newsletter production, public outreach)
SOCIAL EVENTS (holiday parties, picnic, volunteer nights etc.)
VOLUNTEER ADVISORY COMMITTEE (Projects to improve volunteer program)
FUNDRAISING (requires some fundraising experience)
OTHER (Please list other area of interest/ways in which you would like to contribute)

APPROXIMATELY HOW MANY HOURS OF YOUR TIME CAN YOU CONTRIBUTE?

BACKGROUND INFORMATION:

EDUCATION:

PAID WORK EXPERIENCE:

VOLUNTEER WORK EXPERIENCE:

SPECIAL INTERESTS OR HOBBIES:

HOW DO YOU PREFER BEING CONTACTED FOR AN INTERVIEW?
Telephone Email