Volunteer Application Form

All information provided to Citizen Advocacy will be regarded as strictly confidential.

Name:*
Name I prefer to be called:
Address:*
Home Phone:
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Work Phone:
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Cell Phone:
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E-mail (Main):*
E-mail (Other):
How would you prefer we contact you? Check as many as you wish:
Date of Birth (Y-M-D e.g. 1974-09-19):*
Status in Canada:*
If you are in Canada on a Work, Student or Visitor Visa, what date does your permit expire? (Y-M-D):
Indicate which languages you speak fairly fluently:
Preferred language of communication from Citizen Advocacy:
Are you certain you will remain in Ottawa for the next 15 months?:*
How did you find out about Citizen Advocacy? Please be specific (e.g. name of website, name of friend or co-worker):
Upload your resume:
Or provide a very brief resume of your educational and employment experience:
You are interested in volunteering with (check all that interest you):*
What are your reasons for choosing Citizen Advocacy?:*
Why do you want to become a volunteer advocate?:*
What would you say are your strengths as a person?:*
What do you like about yourself?:*
What do you see yourself needing to improve upon?:*
Tell us how wanting to become a volunteer advocate fits with your personal long-term goals:*
How do you see yourself as being able to contribute in a relationship with someone living with a disability?:*
What are you expecting will come out of a match relationship for yourself and the person you are matched to?:*

Submit the name and contact details of three people who have known you well for at least two years. We do not accept references from people who are related on in an intimate relationship with you.

Name Reference 1:*
Phone Reference 1:
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E-mail Reference 1:
Name Reference 2:*
Phone Reference 2:
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E-mail Reference 2:
Name Reference 3:*
Phone Reference 3:
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E-mail Reference 3:
I understand that becoming a volunteer advocate is a long-term commitment to a person who is vulnerable. I confirm that I am prepared to commit to spending the time with a match partner for a minimum of a year from the time we are matched.:*
Date:
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Word Verification: