Apply to be a Volunteer

Personal Information Name
Address
Apartment Number
City
Province
Postal Code
Telephone number
Email Address

Emergency contact information Name
Address
Apartment Number
City
Province
Postal Code
Telephone number
Email Address
Relationship to you

Position Request I am applying for a particular position
I am not applying for a particular position
If yes, which position are you applying for?

Why do you want to volunteer for BALANCE?

Do you speak another language? Which one(s)?

Have you read the volunteering section? Yes
No

What volunteer area(s) interest you? Helping to read mail or correspondence
Helping with household organization
Helping with shopping
Reading on tape
Helping with sports participation
Helping in the BALANCE office
Serving on the BALANCE board or on a committee
Serving as an interpreter
Working on a special event

Do you have any experience working with people
who are blind or vision impaired, or with a social service agency? Yes
No

Please describe your experience.

Other work experience? (Or paste resumé here.)

Please tell us about your educational experience. Include any courses or certifications that you’ve completed.

You will be required to fill out a consent form for a Police Reference Check. Do you have any objections to this? Yes
No

If “Yes”, you object to a Police Reference Check, why?

Reference 1 Name
Address
Apartment Number
City
Province
Postal Code
Telephone number
Email Address
Relationship to you

Reference 2 Name
Address
Apartment Number
City
Province
Postal Code
Telephone number
Email Address
Relationship to you

Why do you volunteer?

Please rank from 1 to 5 the degree to which each statement motivates you. 5 should be the most motivating factor. 1 the least motivating.

Good working conditions 1 2 3 4 5

A sense of being needed and valued 1 2 3 4 5

An opportunity for personal growth 1 2 3 4 5

Meaningful work that interests or challenges me 1 2 3 4 5

A sense of obligation 1 2 3 4 5

A chance to use special (unique) skills 1 2 3 4 5

Fellowship, socialization, friendship 1 2 3 4 5

Recognition for work well done 1 2 3 4 5

A caring and compassionate supervisor 1 2 3 4 5

A chance to be involved in decision-making 1 2 3 4 5

Being involved in an issue of importance; a cause in which I believe 1 2 3 4 5

Career or work experience 1 2 3 4 5

School or course requirements 1 2 3 4 5

Giving something back in gratitude 1 2 3 4 5

Belief about the importance of helping others 1 2 3 4 5

Meeting expectations of people whom I hold in esteem 1 2 3 4 5

Relief from personal negative feelings 1 2 3 4 5

The Program Coordinator will contact you on receipt of your application.

Contact Us

Email:	Click the submit button above or
Fax:	416-236-4280 or
Mail:	BALANCE for Blind Adults 4920 Dundas St West Suite 302 Toronto, ON M9A 1B7

If you need assistance completing this form
please contact BALANCE at (416) 236-1796

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