Volunteer Application Form

    Personal Information

    Full Name

    First Name

    Last Name

    Contact Email

    Contact Phone Number

    Preferred method for correspondence

    Your Address

    Street address

    Street Address Line 2



    Postal Code

    Date of Birth (yyyy-mm-dd)

    This information is not mandatory. Information regarding birthdates is collected to assist in planning and for securing funding for training and resources. i.e. some funding is available to specific age groups. It is personal information, and therefore is protected by privacy legislation. It will not be published or shared, except in anonymous aggregate forms when reporting to funders, authorities, or similar parties.

    Church affiliation (if applicable)

    Skills and Qualifications

    Please check all skills/qualificiations/experiences that apply:

    Please list your other skills, interests, experience or qualifications that you think are relevant to the position or our organization:

    What are you good at?

    Is there anything you can’t physically do, or want to avoid doing for health or personal reasons?

    How did you hear about Island Crisis Care Society?

    Emergency Contact

    First Name

    Last Name

    Emergency Contact Email

    Emergency Contact Phone Number

    Emergency Contact - Relationship to you

    Briefly describe any previous volunteer experience

    Please include durations you volunteered as well.

    What do you feel will be the most rewarding part of the volunteer experience?

    What type of volunteer time commitment are you interested in?

    You can choose multiple.

    Are you able to commit to a 3 month trial period?

    Please specify

    As a method to communicate volunteer opportunities available in both Nanaimo and Parksville, our Volunteer Newsletter is distributed approximately once a month, and you are able to opt-out at any point.

    Use of Information and Acceptance of Terms

    We thank you for your interest in volunteering with Island Crisis Care Society and appreciate you taking the time to complete this form.

    The volunteer selection process involves a number of steps which may include, but are not necessarily limited to, screening, interviews, reference checks, a review of your criminal record check and training. The process is thorough, and may take some time to complete.

    For any given volunteer position, it is Island Crisis Care Society’s policy to choose the individual who bests meets the requirements of the position. These decisions are based on organizational needs, and different criteria depending on the position.

    Information collected on this form will remain confidential to ICCS, and will only be shared with those individuals in our organization with a direct need to know it as part of the volunteer selection and placement process.

    By signing in the field below, you certify that the information provided above is true and accurate to the best of your knowledge, that you acknowledge how Island Crisis Care Society will use this information, and that you accept the terms listed above.

    Please sign in the field below with your mouse.