DATE ______________

NAME ________________________________

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 circle one or more areas which you feel you have time to dedicate to)

1. BEFRIENDING (offering ongoing personal support for a survivor)
2. INTERPRETING /ESCORTING (usually weekdays, during office hours)
3. ESL TUTOR (weekly session with an individual client)
4. PUBLIC EDUCATION (information tables, newsletter production, public outreach)
5. SOCIAL EVENTS (holiday parties, picnic, volunteer nights etc.)
6. VOLUNTEER ADVISORY COMMITTEE (Projects to improve volunteer program)
7. FUNDRAISING (requires some fundraising experience)
8. 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 (You may also attach a resume, if preferred):

EDUCATION ________________________________________________

PAID WORK EXPERIENCE ________________________________________________

VOLUNTEER WORK EXPERIENCE __________________________________________

SPECIAL INTERESTS
OR HOBBIES ________________________________________________________
____________________________________________________________________

Thank you for your interest in volunteering with CCVT. You will be contacted shortly for an initial interview and provided with further orientation.

Mail to:

Attention: Volunteer Coordinator,
Canadian Centre for Victims of Torture
194 Jarvis Street, 2nd Floor
Toronto, ON
M5B 2B7

OR

Fax to: 416-363-2122

Volunteer Program
CCVT home page