General Information Name and Last Names (required) Home Address (required) Postal Address Phone number (required) Email (required) Date of Birth (day-month-year) Work Information Profession (required) Workplace (required) Full or part time? (required) Full-TimePart-Time Section for students School (required) Year / Grade (required) Area of study Only for students who need to fulfill community service hours: Name of teacher in charge Teacher's email (required) Teacher's phone number Information in case of emergency (Two contacts in case of emergency, include name, phone number and relationship with you) First contact Relationship Phone number Second contact Relationship Phone Do you have any physical or health condition that could limit your participation in activities? Please explain: Information about voluntary work and preferences Do you have experience in volunteer work? YesNo If you answered yes, please include a brief description Do you have experience managing activities with children? YesNo If you answered yes, please include a brief description Have you worked directing groups of adults? YesNo If you answered yes, please include a brief description Do you feel comfortable speaking in public or do you prefer office tasks? Speaking in publicOffice Do you feel comfortable working outside, under the sun or in activities where you will have to get wet and/ or be in contact with soil? YesNo Do you get seasick on a boat? YesNo Are you certified in CPR or First Aid? YesNo Do you have any knowledge, experience or talent that motivates you to offer volunteer work? (For instance: was a teacher, is a biologist, knows about harvests, photography, taking video, etc.) Days and hours that you are available: (You may specify AM, PM or night) Sunday Monday Tuesday Wednesday Thursday Friday Saturday Areas of interest VolunteeringScientific CitizenshipGreen Contact Disclaimer and Signature By clicking send I certify that my answers are true and complete to the best of my knowledge. If this application leads to an internship assignment, I understand that false or misleading information in my application may result in my release.
