Youth Volunteer Application Form

-- Confidential --

Please complete the following form as accurately as possible. This will enable us to find you the most satisfying and appropriate volunteer placement with our agency. Thank you! You must be 16 years of age.

Name: ________________________________________________________
(Please print)                  First                                    Last

Address: ______________________________________________________

_______________________________________ Postal Code: ____________

Home Telephone: _____________________ E-mail:_____________________

School: _____________________________ Birth Date: __________________

When are you available to volunteer? (Please list days/times preferred)

Weeknights: Mon______ Tues_______ Wed________ Thur_______ Fri ______

Sat ________________________________Sun: ________________________
(Time) (Time)

How often would you like to volunteer?

Weekly: ______________________________________________________

Monthly:______________________________________________________

Other: _______________________________________________________

How long are you able to commit to volunteering with Literacy Partners of Manitoba?
Three months: ___________ Six months: _________ Other: ________________

Special Skills or Training: (Editing, design, office work, special events, conference prep)
_______________________________________________________________

_______________________________________________________________

Hobbies and Interests:
_______________________________________________________________

_______________________________________________________________

Education/Career Goals:
_______________________________________________________________

_______________________________________________________________

Previous school or community volunteer experience: (use separate sheet if nec.)



What kind of volunteer jobs interest you at this time:

  • Peter Gzowski Golf Tournament for Literacy (prep or on-site help)
  • Publicity (newsletters, posters, PSAs, special events)
  • Office/computer work
  • Public Speaking (High schools, youth groups, etc.)
  • Other ___________________________________________________

Why do you want to volunteer with us? _________________________________

_______________________________________________________________

How did you hear about Literacy Partners of Manitoba?
_______________________________________________________________

Method of Transportation: Transit ___ Family Car ___ Driver’s license? ______

If yes, do you have access to a vehicle? _______ Parent/friend who drives? _____

Are you currently employed? Yes___ No___ If yes, hours per week: ___________

Location: ________________________ Supervisor: ______________________

Your duties include: ____________________________________________________________

May we contact him/her for a reference? Yes ___ No ___ Phone: _____________

In case of emergency please call: ______________________________________

References: Teacher, Coach, Minister. One reference may be family. Please attach resume.

Name Relationship/Organization Telephone Number

l. __________________________________________________________

2.__________________________________________________________

3. __________________________________________________________

I, _______________________________, declare that the information provided is true to the best of my knowledge. I also understand that a criminal record and child abuse registry check as well as reference checks may be required as a condition of volunteering with Literacy Partners of Manitoba, depending on type of volunteer position I accept.

Signature: ______________________________________ Date: ___________________________

Parent signature (if you are under 18): ______________________________________________

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