Centre d’action bénévole de Richmond

New Volunteer Registration

Identification

Last Name *

First Name *

Address (Street Number and Name) *

City *

Postal Code *

Primary Phone *

Other Phone (otherwise enter N/A)

Date of Birth *

CAB Involvement

CABR Registration Date *

Contacts

Contact 1

Full Name *

Relationship *

Telephone *

Contact 2

Full Name *

Relationship *

Telephone *

Health Status

Do you have any health issues that could limit your involvement as a volunteer ? *

Yes No

Additional Information

Languages Spoken *

French

English

Other(s)

Would you be open to volunteering for other organizations ? *

Yes No

If you are interested in transportation assistance or help with errands :

You own a car

You can use it for volunteering

You drive in winter

You drive long distances ( > 90 km )

You have a valid driver's license

If you are interested in transportation assistance or help with errands, please enter the expiration date of your driver's license :

Reference 1

Full Name *

Employer / Organization / Relationship

Telephone *

Reference 2

Full Name *

Employer / Organization / Relationship

Telephone *

Become a Volunteer

Identification

CAB Involvement

Which of the services offered by us are you interested in ? *

Skills *

Contacts

Contact 1

Contact 2

Health Status

Additional Information

Availability :

Additional Information :

Reference 1

Reference 2

Volunteer Involvement