Volunteer Registration
MISSION SERVICES OF HAMILTON, INC.

VOLUNTEER APPLICATION FORM

Applicants must be 16 years of age or older. . (Women's Services volunteers must be female and 18 years of age or older.)

Please enter your information ( All fields are required - if not applicable indicate with NA )
First Name:
Last Name:
Address 1:
Address 2:
Apt #:
City:
Postal Code/Zip Code:
Home Phone#:
Email Address:
Work Phone#:
Work Extension:
Profession:
Emergency Contact:
Emergency Phone#:

Education Completed
Highest Grade Level Completed:
Year Completed:
Post Secondary Education:
Driver's License (YES/NO):
Other Licenses:
Computer Skills:
Special Skills:
Hobbies and Interests:
Languages Spoken:
Languages Read:
Languages Written:

Work Experience
Employer 1:
Position 1:
Dates (FROM/TO) 1:
Employer 2:
Position 2:
Dates (FROM/TO) 2:
Employer 3:
Position 3:
Dates (FROM/TO) 3:

Volunteer Experience
Agency 1:
Responsibilites 1:
Dates (FROM/TO) 1:
Agency 2:
Responsibilites 2:
Dates (FROM/TO) 2:

References
Please give references regarding your employment and volunteer experience
Name 1:
Telephone 1:
Relationship 1:
Name 2:
Telephone 2:
Relationship 2:

Availability
Please clearly state the hours of the day, days of the week, and months of the year you are available and for what length of time you are able to volunteer.
Available Hours of the Day:
Available Days of the Week:
Available Months of the Year:
Available Length of Time:

Questions
How did you hear about our MSH True North Volunteer Program:
Are there any impediments that MSH should be aware of in order for you to complete your volunteer work? (YES/NO):
If so, what are they?:
Do you have access to a vehicle (YES/NO):
Have you ever received service from Mission Services? (YES/NO):
If YES - when ?:
And from which program ?:

Tell us about yourself
Please explain why you wish to volunteer with Mission Services. What do you hope to gain from your volunteer experience?

Volunteer Opportunities
Put a check in the appropriate spaces to indicate your volunteer position preferences.
Community Services (50 Murray Street West)
Front Desk Assistant (reception duties - 3 1/2 to 4 hour shift) office hours Monday to Friday 8:30 a.m.- 4:30 p.m. (immediate need for Monday, Wednesday and Friday mornings.)
Emergency Food Assistant...3-4 hrs/week (Mon., Wed. or Fri. 8:45 a.m.-12 noon, or Wed. 12:45 - 4 p.m.) Choice Room Attendants are required (assisting clients with food selections - some lifting involved) as well as interviewers and greeters.
Van Driver . . . for 2 half days per month - the 3rd and 4th Tuesday afternoon (except July and December when it is the 1st and 2nd Tuesday of the month.)
Clothing/Donations Room sorter and organizer . . . 3 to 4 hour shift on Tuesdays or Thursdays (flexible hours) between 9 a.m. and 4 p.m.
Possible shopper/driver needed (on call) for emergency purchases
Youth Worker Volunteers . . . assist with a youth program (ages 13 - 18) running at Robert Land School at 460 Wentworth Street North. Young adults are required to cover shifts weekdays - Monday to Friday from 3:30 to 6:30 p.m.
Men's Services
Jamesville 2 Kitchen (309 James Street at Barton)
Kitchen assistance (meal preparation, serving, clean up, etc.) for a 4 hour shift between the hours of 8 a.m. and 6 p.m. required on Wednesdays and Thursdays.
Suntrac Addiction Treatment Centre (293 Wellington Street North)
Front Desk Volunteer (phones and admin support - WORD and EXCEL an asset) perfect for an Addictions student. Immediate opening for Wednesday or Thursday night - 4:30 to 8:30 p.m. (some flexibility with start time)
Central Administration Office (293 Wellington Street North)
Front Desk Assistant . . . for 4 hours per week on Tuesday, Wednesday or Friday for shifts from 8:30 a.m. to 12:30 p.m. or 12:30 p.m. to 4:30 p.m., (or full day if desired.) Also require volunteers to cover a short shift from 2 to 4:30 p.m. on Mondays or Thursdays. Assistance with reception, phones, general office duties and mail.
Women's Services - Inasmuch House: Women only (Training quarterly Nov., Feb., May., Sept.)
Answering telephones and doors
Kitchen Volunteer
Activity time for the children
Donations room - organizing and sorting

Volunteer Agreement
Mission Services ackowledges the valuable contributions of volunteers to its programs. We are grateful for the dedication of individuals and groups willing to offer time and effort to help us help others. In fulfilling our mission to respond to the needs of vulnerable people in our community, it is necessary that Mission Services follow specific screening procedures to ensure the safety and protection of our clients, volunteers and staff. Therefore, volunteers are asked to read and sign the following statement as part of the volunteer process.

In applying for volunteer work at Mission services of Hamilton, I understand that false, incomplete or misleading information on the application shall be considered sufficient cause for not recruiting me as a volunteer or for dismissal if so required. After a successful interview, I agree to a Volunteer Criminal Reference Check conducted through the Hamilton Police Services (currently the cost of this is $15.00). I authorize Mission Services to contact the references that I have indicated on the application. I acknowledge that I meet the minimum age requirement of 16 years and understand that some programs within Mission Services may require an older age to volunteer at that particular program.

I understand that Mission Services will review any of their databases regarding any contact I may have had with the agency.

I understand that the information disclosed about me may, but does not necessarily, disqualify me from becoming a volunteer with Mission Services of Hamilton. Following the completion of the screening process, Mission Services reserves the right to decide on the suitability of an applicant for a volunteer position within the agency.

Signature of Agreement
(TYPE NAME):
Date Signed: YYYY/MM/DD
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