volunteer test – BALANCE for Blind Adults

Full Name *

Birth Date (DD/MM/YYYY)

Street Address

Unit

City

Postal Code

Phone Number (please use numbers only. No spaces, hyphens or punctuation.) *

Email *

LinkedIn Profile Link (if applicable):

Currently In:

High School
Post-Secondary Program
Neither

Please give us more information about your education background

Please tell us why you would like to volunteer at BALANCE for Blind Adults

Tell us about other volunteer work or paid work you have done

Are there personal goals, interests or outside activities of yours you would like to share with us?

I am interested in (check all that apply)

Sight on Site (working 1:1 with a BALANCE client under supervision from staff member)
Group programming assistant (helping out with one of our group programs led by a skilled instructor)
Event volunteering (Dates and times will be discussed with you well in advance)
I am flexible, and would like to discuss before deciding

How many hours per week do you see yourself dedicating to volunteering at BALANCE?

Do you speak any languages fluently, other than English? If yes, state language(s)

Emergency contact name

Emergency contact phone number (please use numbers only. No spaces, hyphens or punctuation.)

Reference 1 name (not family members or friends please)

Reference 1 email

Reference 1 phone number (please use numbers only. No spaces, hyphens or punctuation.)

Reference 2 name (not family members or friends please)

Reference 2 email

Reference 2 phone number (please use numbers only. No spaces, hyphens or punctuation.)

BALANCE for Blind Adults Privacy Statement: Volunteer applicants give permission for the collection, creation, use and disclosure of personal information for the purpose of screening for a volunteer role. Successful applicants who become BALANCE volunteers further consent to the collection and use of their personal information in order to facilitate the volunteer staff partnership through volunteer recognition, statistical purposes and tracking of hours and locations. I understand that:

As an adult applicant, I am stating I am over the age of 18
BALANCE for Blind Adults may have a Police Check completed on me, prior to beginning service
I will receive orientation and training prior to be assigned to or commencing any volunteer activities
Volunteering at BALANCE requires a minimum 3-month commitment
I accept the Privacy Statement written above